Please complete one of these forms for each Choice you have completed.  When complete, click on the "Submit" button located at the bottom of this form.  A copy of your post-data report will be e-mailed to you.

Instructor's Name

Instructor's University/College

Submitter's e-mail address

Choice #

Course Title

POST-DATA information (refer to Choices Menu and then list the products that you are submitting to fulfill the post-data requirements for your Choice; after reviewing this Menu hit your "Back" key to return to this form)

Please submit a form for EACH CHOICE you have completed and follow up by submitting the required post-data product documents via e-mail to your regional director at DKlein1st@yahoo.com.  You will receive the second 1/2 of your honorarium upon submission and approval of this form and its corresponding post-data submission(s). 

If you need any technical assistance in completing this form, please contact either Dee Klein or Michelle Hoversten, Project Coordinator, at (330) 672-0735 or mhoverst@kent.edu.

A copy of your post-data report will be e-mailed to you.