"Seeing Radiation: Nuclear Science Experiments" Workshop Registration Form
This is the registration form for the Science Teachers' workshop on Friday, March 11, 2016 at UC Berkeley. The workshop will be held on campus and will be from 8:00am to approximately 5:00pm
1. What is your name? *
Your answer
2. What is your email address? *
Your answer
3. Please select type of registration
4. Have you attended our workshop in the past
5. At which school do you teach?
Your answer
6. Which grade(s) do you teach?
7. Which subject do you teach?
Your answer
8. Will you require any mobility or disability accommodations?
Your answer
9. Please describe any dietary restrictions or allergies of which we should be aware (we will serve a continental breakfast and lunch)
Your answer
10. Will you need a parking pass for UC Berkeley?
The campus is easily accessible by both BART and AC Transit. We encourage you to take public transportation if convenient.
11. What is your mailing address so that we can send out your parking permit?
Your answer
12. Carpooling? Please tell us with whom you plan to ride.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of UC Berkeley. Report Abuse - Terms of Service - Additional Terms