Reservation Request
Attendance is limited to currently enrolled Duke undergraduate and graduate students, postdocs, and faculty.

In order to cultivate a rich experience, attendance is limited and care will be taken to select participants with diverse professional and cultural backgrounds, professional interests, and areas of study.  Submitting this form does not guarantee your attendance at the event. Science & Society staff will be in touch via email with confirmation or notification if you've been placed on a waitlist.

Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Phone Number *
I am a: *
Required
In the department of: *
I study: *
I do research in the following lab (if applicable):
Why are you interested in this specific topic or host? *
Do you need transportation?
Please list any dietary preferences or restrictions:
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.