Speakers List Form
Sign up here to be on our Speakers List! Please try to fill out as much as you can, however if you have any questions about the fields feel free to leave them blank and we'll reach out to follow up! If you would like to nominate another scientist, fill out this form with their information and we'll reach out to them to confirm. Or you can nominate multiple scientists at the bottom of the form. Please make sure you fulfill the requirements below:

1) Identify as a part of a racially/ethnically underrepresented group (we generally follow the NSF definition for underrepresented researchers which includes scientists who identify as Black, African American, Hispanic, Latina/o/x, Indigenous, Native American, and Alaskan Native; however we recognize that this can vary from field to field)
2) Be at the post-doc/resident level or higher
3) Be in a STEM or medical field
4) Have current research that you can present at conferences

Thank you so much! 😊
This information is for:
Clear selection
Preferred Name *
Post-Graduate Degree(s)
Field
You may include more than one field. A list of commonly used fields can be found at this link, however if yours is not present, feel free to still include it: https://docs.google.com/spreadsheets/d/1dB_yiUupXOMoGhHV2qZujikpGszsv2bXCqahl3HBNrI/edit#gid=0
Type of Research
Description (~1 sentence)
Tags
Institution
State
If international, please instead include "Country - City" (i.e. United Kingdom - London)
Zip code
Lab Website
We suggest using your lab website however you can also use your faculty page, LinkedIn, etc
Email
Position (i.e. Assistant Professor, Post-doc, etc)
Do you identify as part of a racially/ethnically underrepresented group? *
This information will not be posted, however it is mandatory so that we can confirm that all scientists highlighted on our list identify as part of an underrepresented racial/minority group! If you identify as underrepresented for other reasons (ie gender, sexual orientation, disability, etc) please let us know under "Other" and we can nominate you for other lists out there!
Ethnicity and/or Race (optional, will NOT be made public)
Gender (optional, will NOT be made public)
Do you identify as a member of the LGBTQ+ community (optional, will NOT be made public. If yes, please specify)
Other Information (optional)
Please include here any other information you would like us to post in the list (i.e. Links to professional social media accounts, articles, etc). This section is not required.
If you know of any other URM scientists that we should include, please list them below!
Please include their names AND one or more of the following: email (preferred), field, institution
How did you find out about us?
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