LG&TBQ Registration
Please fill out the following form to register for "LG&TBQ: a conference in geometry, topology, and dynamics on the work of LGBTQ+ mathematicians" at the University of Michigan, June 10-14, 2019. For more information regarding the workshop see the website: www.math.wisc.edu/~kent/LG&TBQ.html. Thank you for registering.

Unless otherwise noted, all responses are confidential, and will only be viewed by the organizers and administrative staff.

Email address *
Name *
This is the name that will appear on your name badge. It is also how the organizers will address you in any communications. It may be the same as your legal name, or it may be different.
Your answer
Your pronouns
These will be placed on your name badge. Examples of pronouns include, but aren't limited to: She/Her/Hers, They/Them, Ze/Zir/Zirs, He/Him/His.
Your answer
Institution *
This will be placed on your name badge. (``None'' is a valid response.)
Your answer
Position *
If you are a graduate student, who is your advisor? (We will not contact your advisor without your permission.)
Your answer
Advisor's email address
Your answer
Are you an invited speaker?
(Giving a 1 hour or 20 minute talk)
Are you an invited panelist?
Are you interested in giving a 5 minute ``lightning talk''?
Gender
This question is entirely optional. It will be only used in helping set, achieve, and evaluate diversity goals, as well as possibly assigning roommates. Responses will only be viewed by the organizers.
Your answer
Race
This question is entirely optional. It will be only used in helping set and evaluate diversity goals. Responses will only be viewed by the organizers.
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service