K-12 Saturday STEM Workshop
May 9, 2015
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Name to Be Printed on Name Tag
Personal phone number:
Please indicate if that is a cell number or landline.
Please list the name and phone number of an emergency contact.
Grades and subjects you work with:
I DO need lodging for Friday night.
I DO NOT need lodging during the workshop.
T-shirt Size (Men's Sizes)
WYSTEM and i-STEM are committed to diversity and endorses principles of affirmative action. We seek and welcome applications from individuals of all backgrounds, experiences and perspectives. Please indicate any special accommodations including disability-related acommodations you need.
Please indicate any food allergies or preferences to help us with our planning for food on Saturday.
The ethnic background information is being requested to insure equal admission opportunity. Completion of this section is voluntary.
Hispanic or Latino
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Other, please specify
Please tell us how you heard about the Workshop: