NMNEN 3RD WORKSHOP, ALBUQUERQUE NM AUGUST 2010

1. NMNEN 2010 Workshop Registration

 

This workshop is jointly sponsored by a CCLI Phase I award (#0633736) from NSF DUE and CINT

Thank you for your interest in NMNEN,

Boris Kiefer, Vicente Lombrana, Elba Serrano
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1. NAME
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2. POSITION
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3. CONTACT EMAIL
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4. CONTACT PHONE
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5. DEPARTMENT (STUDENTS, IF NOT EMPLOYED, STATE YOUR MAJOR)
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6. INSTITUTION
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7. MAILING ADDRESS
8. Please select the row and column that best indicate your intended participation.
I will submit materials for disseminationI will NOT submit materials for dissemination
I will attend
I might attend
I will not attend
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9. STATUS:PLEASE SELECT ALL THAT APPLY
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10. STUDENT STATUS:PLEASE SELECT ALL THAT APPLY
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11. Please indicate all your degrees
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12. Please provide a brief bio (50-150 words) for the program
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13. Briefly describe your interest in nano(bio)science education.
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14. Briefly describe the materials you will share with other participants.
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15. COURSE OFFERINGS: Which COURSES do you offer? Please select all that apply (Students, select n/a if you have not offered a course)
elementary school studentsmiddle school studentshigh school studentslower division UG studentsupper division UG studentsgraduate studentsonline studentsfacultyn/a
biology COURSES for
physics COURSES for
nanoscience (no life science emphasis) COURSES for
nano(bio)science COURSES for
research/scientific ethics COURSES for
other STEM courses not listed above
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16. BACKGROUND: Which COURSES or WORKSHOPS have you taken in the following areas?
lower division UG studentsupper division UG studentsgraduate studentsonline studentsfacultyn/a
biology for
physics for
nanoscience (no life science emphasis) for
nano(bio)science for
research/scientific ethics for
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17. PLEASE SELECT ALL THAT APPLY
18. OPTIONAL DEMOGRAPHIC DATA. Select any that apply to you and that you wish to provide to us.
19. If available, Please provide a link to your web page.
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20. How did you hear about the workshop? Please select all that apply
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21. How long did it take to complete this form?
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22. DATE
MM DD YYYY
Today's date
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