2019 STEM in the Park Pre-Registration
Please pre-register to attend the 2019 STEM in the Park event 'Go GREEN with STEM' to be held on Saturday, September 28, 2019 at BGSU's Perry Field House.
Email address *
First Name *
Your answer
Last Name *
Your answer
City of Residence *
Your answer
State of Residence *
The following questions are about you and the people you will bring to STEM in the Park. For each question, enter the number of people who will be coming to the event with you. (Each family should complete their own registration, so if you plan on coming with multiple families, please only consider your own family for the questions below.)
# of Adults in Your Group *
(including yourself)
# of Children Age 0 – 2 Years
# of Children Age 3 – 5 Years
# of Children Age 6 – 10 Years
# of Children Age 11 – 13 Years
# of Children Age 14 – 18 Years
Total # of Children who are FEMALE
Total # of Children who are MALE
# of Children who would identify as WHITE, NON-HISPANIC
# of Children who would identify as HISPANIC
# of Children who would identify as MIDDLE EASTERN
# of Children who would identify as MULTIRACIAL
# of Children who would identify as BLACK, NON-HISPANIC
# of Children who would identify as ASIAN/PACIFIC ISLANDER
# of Children who would identify as AMERICAN INDIAN/NATIVE ALASKAN
How did you hear about STEM in the Park? *
Check all that apply.
Required
Photo/Video Release Information
Pictures/Video will be taken at this event and used for promotional purpose for future NWO activities.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service