WOMEN IN SCIENCE CONFERENCE TEACHER/CLASS RESERVATION SHEET
University of Wyoming Campus, Laramie, WY
The conference is on a first come, first serve basis for 350-500 students. This form will help us plan attendance. We will contact you as the conference gets closer to verify the number of people able to attend and to sign up individual participants. Please list the names and e-mails of all teachers (or group leaders) who will be bringing students from the same school/organization (so we can avoid duplicate registrations). The conference is open to 7-12th grade students, regardless of gender (although the conference will be aimed at young women – please be aware that there will be workshop presenters of both genders participating in the conference). Please fill out the total number of students you would like to bring, however we may have to limit the size of large groups depending on the number of schools that sign up.
DATE:TEACHER NAME(S):
SCHOOL:
SCHOOL ADDRESS:
SCHOOL PHONE:
TEACHER EMAIL(S):
STUDENT GRADE(S): / APPROXIMATE NUMBER OF STUDENTS:
We may be able to offer some grants to help cover travel expenses for classes traveling long distances.
Should these funds be available, the travel grants will be (choose one)…
Essential / Helpful / Unnecessary / Other:
…for my class’s participation in this event.
For questions about the program, contact the Space Grant office at (307)766-2862 or email us at .
ELECTRONIC SUBMISSION: Download this form, fill it out, save it, and submit it as an e-mail attachment to with “WIS” in the e-mail subject line.
PAPER SUBMISSION: Either fill out the form electronically and print it or print the blank form and fill it out by hand. Then mail or fax the form to:
Wyoming NASA Space Grant Consortium Fax: (307)766-2652
Department of Physics & Astronomy
Dept. 3905
1000 E. University Avenue
Laramie, WY 82071
Wyoming NASA Space Grant Consortium
http://wyomingspacegrant.uwyo.edu