2024 CCCC Professional Equity Project Registration Form - National Council of Teachers of English

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2024 CCCC Professional Equity Project (PEP) Registration Form

Please complete the form below in-full by Wednesday, January 3, 2024. We will use this information to process your complimentary 2024 CCCC Annual Convention registration and CCCC/NCTE membership. Please email cccc@ncte.org with questions.

Email Address*
CCCC/NCTE Member ID # (if you have one)
Are you a current CCCC member?*
- Yes
- No
Are you a current NCTE member?*
- Yes
- No
Are you a student?*
- Yes
- No
Are you a part-time instructor or contingent faculty member, retiree, or veteran?*
- Yes
- No
Name as you wish it to appear on your badge:
First Middle Last
Personal Pronouns (Personal pronouns will be printed on badges)*
If you answered "None of the above" for personal pronouns, please enter your preferred pronouns below:
Preferred Social Media Handle
Title*
Institutional Affiliation/Organization*
Address*
Address LIne 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Is this your first in-person CCCC event?*
- Yes
- No
ADA Accommodation
- Yes
- No
Please specify the ADA accommodation(s) needed:
Please let us know if you have any dietary restrictions:
I agree to the NCTE Event Policies https://cccc.ncte.org/cccc/ncte-event-policies/*
- I agree
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