Power Connection: Reshaping the Future for Women in STEM - Workshop Application
Thank you for your interest in the Power Connection: Reshaping the Future for Women in STEM workshop. We are happy to review your application to be a participant in our upcoming workshop for 2019!

To help us maximize your experience please fill out the form below. We want to better understand your training needs and professional goals. Also, please note that spaces for these workshops are limited to 32 participants per-event. So, unfortunately, not all applications will be accepted.

If your application is accepted, you will receive the registration form and hospitality information -- generally within 7 business days. The early bird registration price is $850 (ends on October 1). Regular registration is $1200. We look forward to meeting you soon and congratulations for taking this important step forward in your professional career.

First Name *
Your answer
Last Name *
Your answer
Institution / Company *
Your answer
Department *
Your answer
Position / Title *
Your answer
E-Mail *
Your answer
Phone Number *
Your answer
Have you ever attended an Alda Center / ACT workshop before? *
What is your motivation for attending this workshop? *
Your answer
Which workshop would you like to attend? *
What are your main communication challenges? *
Your answer
What obstacles/challenges do you see facing Women in STEM? *
Your answer
What solutions have you seen work well (for yourself or others) to address some of the obstacles/challenges you listed in the previous question? *
Your answer
At your discretion, please share situations or conversations in your workplace that you have difficulty navigating. We may anonymously use these examples during the workshop.
Your answer
Please provide a brief biography (100 words). This information will be available to your instructors and fellow participants on the day of the workshop. *
Your answer
Please indicate any dietary restrictions (check all that apply): *
Do you have any special requirements we should be aware of in advance? Please describe.
Your answer
Additional comments or questions?
Your answer
We look forward to meeting you soon!
If you'd like to speak with a member of our workshops team in advance, please e-mail us at: workshops@aldacommunication.com

Power Connection is a joint program collaboration between the Alan Alda Center for Communicating Science and Alda Communication Training. Power Connection™ 2019. All Rights Reserved. www.aldacenter.org

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