1. Application Form:

Thank you for your interest in applying for the Experiential Learning Symposium. The EL Symposium is Brandeis' only campus-wide, interdisciplinary symposium. We look forward to your participation.

*Please note that this year there is a new presentation format option! Students may select to do a multimedia presentation in the form of a PowerPoint, video, or beyond! Please visit the EL Symposium website to learn more about the presentation parameters.

If you wish to present a multimedia product, please know that presentations should be between 2-3 minutes long and that all multimedia presenters will be responsible for their own laptop. For those needing to borrow a laptop, please visit the link provided:

Final Deadline: February 27, 2012

1. Please provide the following information.

2. What is your

3. Students presenting a poster/ multimedia presentation are required to be at their display during the entire poster/ multimedia session: March 22, 2012 from 5:00-6:30pm. If you have a course requirement during that time, please discuss with Lexi Kriss, Department Administrator for Experiential Learning (akriss@brandeis.edu).

I am submitting an application to be considered for

4. If you are applying for more than one opportunity (e.g. a group poster AND an individual presentation), you will need to submit separate applications for each. One application per poster/presentation. I am applying as

5. If applying as a group project, please provide a list of all who wish to present, including email addresses, majors/minors, and years of graduation.

6. The title of my presentation is (this title will be used in the event program):

(EX: Role of Stakeholders in the Clean Technology Industry)

7. We are planning to group presenters in similar categories. Please select your preferred group.

8. If your Experiential Learning experience belongs to more than one group, please check all that apply.

9. Please provide a description of your project (150 words). This description will be published in the symposium program, so please take care to write your description as you would like others to see it. In addition, please remember that attendees from many different disciplines will be in attendance and that your description should be easily understood by all.

Sample Description: "My senior thesis project investigates the knowledge, beliefs, and values of Brandeis undergraduate students about genetic and genomic testing. My research draws on in-depth interviews with twelve students from a variety of majors. These interviews explore Brandeis students' beliefs about their health and their opinions about the effects of genetic testing on both a personal and a societal level. Because genetic and genomic testing is projected to greatly affect healthcare, as well as the insurance industry and other aspects of our lives, I wanted to start a dialogue with my peers about these emerging technologies. My research has pushed me to think creatively and analytically, and I hope my project will lead to further research on the public opinions and concerns surrounding genetic and genomic testing."

In your description, please answer the following:
1. What did you do?
2. What did you learn?
3. How can you apply what you learned in the future?

10. Undergraduate presenters must have a symposium mentor who can help them with presentation preparation. Please indicate your faculty/staff mentor or internship supervisor below.

11. Have you received any financial funding from either on-campus or off-campus sources to support your experiential activities? Examples include WOW Fellowships, NIH Grant Funds, Jane's Travel Grants, etc. Please indicate all that apply.

12. How did you hear about the symposium? Please be specific.

13. If you have any additional comments, please add them below.