2017-18 Science Mentor Interest Form
Please complete this form if you are interested in mentoring for the Madison Middle School Science Symposium Program OR supporting science learning in our schools through mentoring during the 2017-18 school year. You will be contacted in the fall (August/September) to confirm your commitment and to complete an additional survey about your interests and availability to work with our program(s). If you have any questions, please contact: Patti Schaefer, Science Coordinator, psschaefer@madison.k12.wi.us. Thank you in advance for your willingness to support MMSD students in science!
First Name *
Your answer
Last Name *
Your answer
Affiliation. This could include, but is not limited to: UW/Madison College/Edgewood Student/Grad. Student/Professor, High School, Your place of business (Thermo Fisher, Epic, Dental Office), Parent, etc. *
Your answer
Email address *
Your answer
I would be interested in mentoring (check all that apply):
I could support science learning through mentoring in the following way(s):
Our program requires that we recruit 100+ mentors each year. If you know of any additional people, organizations, departments, businesses, etc. whom you think might be interested in mentoring, please share this information with them or provide a contact name and email below.
Your answer
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