WISE Conference Interest Form

1. Columbia University WISE Conference Interest Form

The WISE Conference will be held on December 4, 2015 at Columbia University. We look forward to seeing you there!

The WISE Conference is an opportunity for women who are interested in pursuing graduate education in science or engineering disciplines to learn about the graduate school application process, funding opportunities, the day-to-day realities of being a woman in graduate school, and possible career paths. Join us for a day of programming to celebrate, promote, and encourage women to pursue graduate degrees in science and engineering.

Please refer to our website for more information: http://columbiawise.weebly.com/

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* 1. Please provide the following demographic information

First Name: *

Last Name: *

Address 1: *

Address 2:

City/Town: *

State: *

ZIP: *

Country: *

Email Address: *

Phone Number:

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* 2. Undergraduate College/University

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* 3. Current Student Status

First Year

Sophomore

Junior

Senior

Other

Other (please specify)

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* 4. Indicate College Major

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* 5. Graduate Degree Level of Interest

M.S.

Ph.D.

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* 6. Graduate School Subject of Interest

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* 7. When do you plan to enter graduate school?

	Semester	Year
I plan to enter in	I plan to enter in Semester menu	I plan to enter in Year menu

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* 8. What questions would you most like to have addressed by attending the WISE conference? (Please list any questions you may have in a particular category below so that we may answer them during or before the conference.)

Questions regarding Admissions and Financial Aid?

Questions for women who have built successful careers in engineering?

Questions for the Graduate Student Panel?

Questions, other?

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* 9. WISE agreement

By submitting this form I understand that I will be added to the WISE conference listserve and that I may remove myself at anytime. (We will use the listserve to keep you informed as we roll out our Facebook and Twitter accounts and the latest news on our WISE speakers.)

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* 1. Please provide the following demographic information

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* 2. Undergraduate College/University

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* 3. Current Student Status

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* 4. Indicate College Major

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* 5. Graduate Degree Level of Interest

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* 6. Graduate School Subject of Interest

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* 7. When do you plan to enter graduate school?

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* 8. What questions would you most like to have addressed by attending the WISE conference? (Please list any questions you may have in a particular category below so that we may answer them during or before the conference.)

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* 9. WISE agreement

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* 10. How did you hear about the WISE program?