All four events are currently full, if you are interested in being on the waiting list, please email Caleb Cheung.

Thank you for your interest in being a featured scientist at one of the 2016 OUSD Dinner with a Scientist events. Use this site to register only if you belong to one of our partner organizations or have contacted Caleb Cheung in advance.

Guest scientists are the main feature of this event. By registering, you are making a firm commitment to participate. If you are interested, but cannot fully commit at this time, please indicate accordingly in question #3.

All scientists are expected to attend the entire event from 5-8 pm. You will have the opportunity to share about your work, answer questions, and lead a short activity at your table related to your work. We are happy to help you plan the activity if you need assistance.

The information below will be used in the event program. Please make sure all information is grammatically correct.

Click here to view the invitation letter with more details about the event.

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* 1. FULL First and Last Name

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* 2. We might have a need for scientists to attend more than one event. How many events might you be interested in attending? We will confirm early April.

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* 3. Please select the dates you can attend. We will finalize the dates mid April.

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* 4. Have you participated in any Dinner with a Scientist events in the past?

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* 5. Work Place or Organization Affiliation

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* 6. Please provide the name of the partner organization (if different from above) and the name of the person who invited you to participate.

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* 7. Job Title (please use a title that makes the most sense to students, shorten long official titles to <20 characters)

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* 8. Scientific Field (Chemistry, Paleontology, Electrical Engineering, Medicine, etc.)

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* 9. Mark any group(s) that describe your background. Please note that the purpose of this question is to support our recruitment of underrepresented groups in the science profession. (Check all that apply)

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* 10. Please provide your contact information. This will be kept private from other participants.

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* 11. Work Phone Number

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* 12. Cell/Home Phone Number (for emergency use only)

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* 13. Email Address (communication will be primarily by email)

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* 14. I give permission to release the following contact information to the teachers and students in attendance. Check all that apply.

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* 15. The dinner will include vegetarian options. Let us know if you have any other dietary needs. We will try our best to accommodate you.

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* 16. Provide a short biography for the event program in first person. Details can include your education, a brief work history, WHY you went into science, WHAT sparked your interest in science, and anything that would encourage young people to enter the field of science. This will be included under your name in the event program. Please use student friendly language. For sample bios, please view one of our past event programs. (75 words max)

If you are a returning scientist and would like us to reuse your bio from previous years, please indicate accordingly below.

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* 17. Please describe the activity you plan on sharing with students at the dinner table. The activity should be ~10 minutes, hand-on, and engaging. Keep in mind that you will be conducting the activity around food and with three different groups through out the evening. Access to electricity is extremely limited. Please let us know if you need help planning an activity.

Thank you! Please click "done" when you are finished. We look forward to having you join us and will contact you three weeks before the event with more information. If you have any questions, contact Caleb Cheung.

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