STEM Exploration Day for Girls: Workshop Selection Form

STEM Exploration Day for Girls: Workshop Selection Form
Student Name: ___________________________________ School:__________________________________
Adult t-shirt size (check one): □ Small □ Medium □ Large □ X-Large □ 2XL-Large □ 3XX-Large
Registration fee: $40 per student or chaperone (includes program registration, materials, lunch and a t-shirt). All
students must bring a parent-signed liability and photo release form with them to the event in order to participate.
Forms created by schools will NOT be accepted. Scholarships are available to students.
At STEM Exploration Day for Girls I will attend 3 workshops. I understand that space in the workshops is limited, so I
ranked my favorite top eight workshops and chose two workshops that I would rather not attend. I understand that by
ranking my workshops, chances of attending workshops of interest to me increases. I will be notified of my workshop
placement at least one week prior to the event date of February 26, 2016.
Available workshops can be found here:
I REALLY WANT TO ATTEND these workshops! I ranked my 1st through 8th favorite workshops by complete title below.
My first choice: _____________________________________________________________________________
My second choice: __________________________________________________________________________
My third choice: ____________________________________________________________________________
My fourth choice: ___________________________________________________________________________
My fifth choice: _____________________________________________________________________________
My sixth choice: _____________________________________________________________________________
My seventh choice: __________________________________________________________________________
My eighth choice: ___________________________________________________________________________
I would rather NOT ATTEND the following two workshops. None of my favorite workshops above match the
workshops I do not want to attend below.
I do not want to attend: ______________________________________________________________________
Or this one either: ___________________________________________________________________________
This is not a registration form for STEM Exploration Day for Girls. Use this form to register students through the online
registration link at the above website.
Registration will open at 3:45 p.m. on January 21st, 2016. Pre-registration is required online by January 29, 2016 and
onsite registration will not be accepted. Registrations received after January 29, 2016 will be placed in remaining
workshops by event staff and only if available. This program fills quickly and will close when capacity is met.
Registration on opening day is highly encouraged.
Contact Samantha Pech, Outreach Specialist, Continuing Education and Outreach, UW-Stevens Point if you have any
questions at 715-346-4593 or [email protected]