2012 GSRA Conference Registration Survey

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1. Please provides the following information to register for the 2012 Graduate Student Research Association Conference at Northern Illinois University.

Please provides the following information to register for the 2012 Graduate Student Research Association Conference at Northern Illinois University. Name:
Address:
Address 2:
City/Town:
State:
ZIP:
Email Address:
Phone Number:

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2. Are you a currently enrolled NIU student?

Are you a currently enrolled NIU student? Yes

No

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3. What is your email address?

What is your email address?

4. Current NIU students only: Provide your Z-ID number:

Current NIU students only: Provide your Z-ID number:

5. If you are an NIU student, what is your status?

If you are an NIU student, what is your status? Graduate student

Student-at-large

Undergraduate student

6. If you are not a currently-enrolled NIU student, what is your status?

If you are not a currently-enrolled NIU student, what is your status? NIU faculty or instructor

NIU staff member

Community member: K-12 student

Community member: K-12 teacher/administrator

Other (please specify)

7. If you are an NIU student, faculty member, instructor, or staff member, what is your department?

If you are an NIU student, faculty member, instructor, or staff member, what is your department? Academic Affairs

Accountancy

Anthropology

Athletics

Audiology

Biological Sciences

Business Administration

Chemistry & Biochemistry

Clinical Laboratory Sciences

Communication

Computer Science

Counseling, Adult, & Higher Education

Economics

Educational Technology, Research & Assessment

Electrical Engineering

English

Finance

Finance & Facilities Division

Foreign Language & Literatures

Geography

Geology & Environmental Geosciences

Health Education

History

Industrial & Systems Engineering

Kinesiology & Physical Education

Law

Leadership, Educational Psychology & Foundations

Literacy Education

Management

Marketing

Mathematical Sciences

Mechanical Engineering

Military Science

Nursing

Office of the President

Operations Management and Information Systems

Outreach, Engagement & Information Technology Services

Philosophy

Physical Therapy

Physics

Political Science

Psychology

Public Administration

Public Health

Rehabilitation Counseling

School of Art

School of Music

School of Theatre & Dance

Sociology

Special & Early Childhood Education

Speech-Language Pathology

Statistics

Student Affairs

Technology (Engineering)

University Advancement

University Relations

University Libraries

Women's Studies

Other (please specify)

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8. Are you a presenter at the 2012 GSRA Conference?

Are you a presenter at the 2012 GSRA Conference? Yes

No

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9. Are you attending the Conference for...

Are you attending the Conference for... Entire day

Morning sessions only

Morning sessions and keynote speaker

Afternoon sessions only

Afternoon sessions and keynote speaker

Keynote speaker only

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10. Do you need any disability related accommodations to attend or participate in the GSRA Research Conference?

Do you need any disability related accommodations to attend or participate in the GSRA Research Conference? Yes

No

If "yes," please indicate accommodations needed:

11. I would like to be added to the GSRA mailing list so that I can receive information about GSRA events

I would like to be added to the GSRA mailing list so that I can receive information about GSRA events Yes

No

12. If you wish to be added to the GSRA mailing list, please provide your email address

If you wish to be added to the GSRA mailing list, please provide your email address

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2012 GSRA Conference Registration
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