Girls In STEM at Tulane

SPRING 2016 ONLINE REGISTRATION FORM - MARCH 5TH

Tulane University’s GIST Program provides fifth through eighth grade girls with the opportunity to meet and work with women role models in science, technology, engineering, and mathematics (STEM) fields. Workshops developed and offered by Tulane faculty and Tulane student teams encourage and empower girls to inquire, investigate, and discover in a positive environment. Our goal is to open the doors wide and welcome young students to careers in STEM fields by encouraging creative thinking, promoting self-esteem, and increasing awareness of the opportunities that await them. More information can be found at: website.

Instructions: Please have all necessary information before beginning to fill out this online registration form. If you have any questions regarding this form, please email gist@tulane.edu or call Dr. Michelle Sanchez at 504-865-5088.

NEW FOR SPRING 2016: Participants with complete applications including payment and forms will be accepted on a first come/first serve basis. After the registration has been received, you will get an email asking you to mail in your payment and forms ahead of time to secure your participant's spot. After the payment and forms have been received, you will get another email with an official acceptance and more details about our Spring GIST. Thank you for your understanding and cooperation.

PARTICIPANT'S INFORMATION

First Name:                Last Name: 
Birth Date:    format: mm/dd/yyyy        Sex (for girls only):
Grade (required):                                T-Shirt Size (required):
Please select one or more races from the following six racial groups that best describes participant's ethnicity (optional):
American Indian or Alaska Native    Asian    Black or African American    Hispanic or Latino    Native Hawaiian or Other Pacific Islander    White
 
Please select one or more reasons participatant is interested in GIST (fill out together with participant):
I love science    I love technology    I love engineering    I love math    I’m curious about Tulane – what’s college like?
I want to do hands-on experiments    My friend is going and talked me into it    My mom, dad, or guardian made me do it!    I’m in it for the pizza
 
Has your particpant attended GIST before?                 If so, how many times?   
If you answered yes to the question above, please provide a brief description of the workshops that participant attended.

max: 250 characters

PARENT'S OR GUARDIAN'S INFORMATION

First Name:    Last Name: 

Address:

City:

State: LA       Zip:
Phone :  format: 504-123-4567       Relationship:
Email:

SCHOOL INFORMATION

School:

City:

ADDITIONAL INFORMATION

Are there any allergies or health constraints that may prevent participation in any scientific activities? Note: Group leaders are NOT medically certified in any way. Tulane cannot administer any medicine to participants. Parent/Guardian will be required to come to event to adminsiter any medications.
If yes, please describe how participant will receive medications.
Allergy Description:

max: 250 characters

It is our goal to offer a universally accessible program. If you anticipate needing any type of reasonable accommodation or have questions about campus accessibility, please describe your need here.
Accomodation:

max: 250 characters

Does participant wish to be in the same group as friends? Please list name(s) and the corresponding schools (if known) here. We will do our best to accomodate these requests.

max: 250 characters

Any Additional Comments:

max: 250 characters