CIKM - Women's Perspectives on Research and Development at Google Panel
The Women's Perspectives on Research & Development at Google Panel will be hosted on Monday, October 28th from 6-9 pm at our YouTube office.

Please complete the following form to let us know why you'd like to join us for the panel at CIKM. Through the forum experience, we'd like to offer participants an opportunity to connect with members of Google's technical team, hear individual perspectives on research at Google and ask us questions about our research and product development.

Space is limited, but we'll accommodate as many participants as possible. We’ll review all responses to this form and prioritize those whose interests in participating align well with the objectives of the forum experience.

Once added to the guest list, we’ll send you a confirmation email that includes the location of the event. We'll confirm participation no later than Friday, October 25th. Direct questions to

Google's use of this data is governed by our privacy policy found at

Are you attending this event? *
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Company / University Affiliation *
Your answer
Your answer
Research Area *
Your answer
Please tell us why you would like to attend this event. *
What specifically interests or intrigues you about the experience we'd like to offer?
Your answer
Would you like to be contacted about future Google events and opportunities? *
Please let us know if there are any special accommodations that we need to be aware of in order for you to attend this event.
Your answer
How did you hear of this event?
What size t-shirt would you like? *
Your answer
Photo Release *
By accepting this waiver, I acknowledge that I have read, fully understand, and agreed to the following terms for Google to use audiovideo footage, my appearance in a video, and/or my photograph. ● I hereby grant Google Inc. permission to copy, host, index, display, route, reformat, distribute, store, transmit my image, photos/video through the internal or external distribution mechanism indicated in the checkboxes above. I grant Google a royaltyfree, perpetual, worldwide license to any copyrights, rights of publicity, and any other legal rights necessary in order for Google to make this authorized use of the photos/video. ● I warrant that I have the authority to grant this permission and to make the acknowledgments and consents set forth herein on behalf of my company, to the extent that my company’s permission, acknowledgment or consent is required. ● I acknowledge that I will not be paid (nor will my company, if applicable) for use of the audiovideo footage and/or transcript of my presentation and hereby relinquish (and with respect to my company, if applicable) any past, present, or future monetary or other claims against Google for this use. I also waive (and with respect to my company, if applicable) any moral rights that I might have in my name, likeness or presentation.
Never submit passwords through Google Forms.
This form was created inside of Privacy & Terms