Organic Electrochemistry Short Course Application Page Organic Electrochemistry Short Course Application Please provide the information below to apply for participation in the Organic Electrochemistry Short Course. Available lab space will limit participation to 16 individuals. Efforts will be made to create a diverse collection of academic and industrial researchers. Applicants will be selected and notified, starting in mid-March, and will be provided with registration information. Name* First Last Email* Phone*Institution/Company*Registrant Type* Graduate Student/Postdoc Faculty/Instructor Industry Please provide a brief summary of your background and interest in organic electrochemistry and how you anticipate using the insights gained from this course in the future.*Consent* I agree to the course registration policy.The registration fees for this course are as follows: Graduate Student/Postdocs $595, Faculty/Instructors $895, Industry $1695. I agree that if selected to participate, I will register for the course and pay the registration fee within one week of notification. If I am unable to pay the registration fee, I agree to forfeit my spot in the short course.