CHECK Program Workshop - Expression of Interest Question Title * 1. Your Name: Question Title * 2. Your position title: Question Title * 3. Email address: Question Title * 4. Name of Organization, School, Business, or Institution: Question Title * 5. Which workshop are you registering for? Chatham University Eden Hall Campus on March 10 RE Farm Cafe in State College on April 21 Swarthmore College on May 23 Question Title * 6. How likely is it that your organization, school, business, or institution will install induction cooking equipment within the next year? Already planning to install induction cooking equipment Very likely to install induction cooking equipment Might install induction cooking equipment Unlikely to install induction cooking equipment Question Title * 7. Please explain in 1-3 sentences why you are interested in attending this workshop. Question Title * 8. Do you feel you could be swayed into purchasing induction cooking equipment if educated on the topic? Yes No Possibly Question Title * 9. Have you participated in one of DEP’s CHECK webinars? (NOTE: To be eligible for the rebate, applicants must either watch a webinar OR attend an in-person induction workshop. Recorded webinars can be viewed at any time at our website) Yes, I participated in a live webinar No, but I have viewed a recorded webinar No, I have not participated in or viewed a webinar Question Title * 10. Does your organization, school, business, or institution already use induction cooking equipment? If so, list the equipment used. No Yes Done