Name
*
First Name
Middle Name
Last Name
Email Address
*
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Phone Number
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Address
*
Street Address
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City
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Why are you interested in girls in STEM?
*
Field of Study—Briefly describe your field of study/STEM expertise in 1-2 sentences.
*
STEM Program Idea—Describe a 20-minute hands-on STEM program for families (~25 people ranging from ages 5–75) that you would facilitate. Describe the content you will cover, materials needed, and how you will engage children and families.
*
Please describe any outreach work you have done involving girls in STEM
*
File Upload—Please upload, as one PDF document, a CV, brief description of the scientist’s area of study and/or research, examples of public outreach and/or programs targeted at girls in STEM, and contact details for three references who can attest to the scientists outreach experience. File size limited to 10MB.*
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