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Thank you for inquiring about our grant-funded activities.

~ Donna Milgram
~ Executive Director, Institute for Women in Trades, Technology and Science

Are you interested in receiving information about our grant-funded online training and support where you will learn to increase the number of women in your STEM program(s)? The training is 10 weeks long, with asynchronous and synchronous components, followed by 6 months of follow up support. Each participant must commit to participate fully.

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* 1. Are you interested in receiving information about our grant-funded online training and support where you will learn to increase the number of women in your STEM program(s)? The training is 10 weeks long, with asynchronous and synchronous components, followed by 6 months of follow up support. Each participant must commit to participate fully.

Are you interested in receiving information on free webinars on specialized topics on recruiting and retaining women in STEM?

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* 2. Are you interested in receiving information on free webinars on specialized topics on recruiting and retaining women in STEM?

Last Name

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* 3. Last Name

First Name

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* 4. First Name

Job Title

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* 5. Job Title

Email Address

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* 6. Email Address

City

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* 7. City

State

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* 8. State

Institution

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* 9. Institution

Are you connected to an ATE Project or Center?

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* 10. Are you connected to an ATE Project or Center?

ATE Grant Number and Title (if applicable):

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* 11. ATE Grant Number and Title (if applicable):

Role in Grant (if applicable):

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* 12. Role in Grant (if applicable):

Member of The League for Innovation in the Community College:

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* 13. Member of The League for Innovation in the Community College:

Member of The American Association for Community Colleges:

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* 14. Member of The American Association for Community Colleges:

Grade level(s) you work with (choose only one)

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* 15. Grade level(s) you work with (choose only one)

My job is best described by the following category:

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* 16. My job is best described by the following category:

What is the major career pathway (s), if any, that you are connected to? i.e. nanotechnology or computer networking.

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* 17. What is the major career pathway (s), if any, that you are connected to? i.e. nanotechnology or computer networking.

Other Comments:

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* 18. Other Comments:

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