Registration Form

Fall Storytelling Seminars
Various dates & times
S 304 Memorial Union
What is your last name?

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* 1. What is your last name?

What is your first name?

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* 2. What is your first name?

What is your degree program?

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* 3. What is your degree program?

Please indicate if you are a...

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* 4. Please indicate if you are a...

What is your email address?

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* 5. What is your email address?

At what phone number can we reach you?

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* 6. At what phone number can we reach you?

Dr. Burch will offer two sessions on two different days. (Each session will have the same content.) Please indicate your session preference. Each session will be limited to the first 20 people who sign up for that session.
Please indicate your date choice for storytelling:

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* 7. Please indicate your date choice for storytelling:

Are you participating in the Mizzou 3MT competition this year?

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* 8. Are you participating in the Mizzou 3MT competition this year?

What is the working title of your thesis or dissertation research project?

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* 9. What is the working title of your thesis or dissertation research project?

In 2-3 sentences, explain why your research will serve to benefit the public:.

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* 10. In 2-3 sentences, explain why your research will serve to benefit the public:.

Thank you very much for pre-registering. You will receive a confirmation a few days before your event.. If your plans change, please let Dr. Walker know as soon as possible. You must read Dr. Milbre Burch's handout  before you attend the session. Thank you!

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