STEM Conference Fall 2021- Moderator Registration Form
This form is to gather information about Undergraduate Student Volunteers who are interested in being a Zoom room moderator for the Fall 2021 STEM Conference.

The conference is November 10th to November 12th (1-4pm) on each day so please be as open as possible about your availability so that we can set you up to moderate at the best times.

Moderators will be required to provide contact information and will need to join the GroupMe to stay up to date on events pertaining to the conference.
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Email *
Full Name
GSU Email *
Phone Number (e.g 333-333-3333) *
What is your organizational affiliation? *
Availability (Nov. 10 - Nov 12)
1-2 pm
2-3 pm
3-4 pm
Wednesday 11/10
Thursday 11/11
Friday 11/12
Any special comments regarding you availability (e.g "Likely to change" or "might have work at xyz")
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