First name*
Last name*
Preferred name
Department or work unit (e.g. Office of the Dean, Asia Institute)
Position Title*
Employment type
Staff number
Staff username (e.g. jsmith)
Student ID
Student username (e.g. jsmith)
Preferred email address*
Currently teaching?
Please tell us the faculty or faculties you are teaching in
Please tell us the subject or subjects you are teaching in
How did you hear about the program/event?*
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