2019 VC STEMposium Participant Registration
Sign in to Google
to save your progress.
Learn more
* Required
Email
*
Your email
STEMposium ID (This ID will be used on all data collection surveys)
*
8-digit Birthdate and last 2 digits of phone number (ex. for the birthdate Dec. 3, 1982 & phone # 340-9850, your 10 digit ID would be 1203198250)
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Cell Phone
*
Your answer
School District
*
Your answer
School Site
*
Your answer
Session Grade Level (this is the grade level you are signing up to attend)
*
Choose
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
MS: 6th Grade
MS: 7th Grade
MS: 8th Grade
HS: Biology
HS: Chemistry
HS: Earth Science
HS: Physics
HS: other
Years teaching science
*
Your answer
Previous STEMposiums attended
*
2015, Year 1
2016, Year 2
2017, Year 3
2018, Year 4
none attended so far
Required
Thank you for registering for the 2019 Ventura County STEMposium. You will be receiving more information through email as we get closer to the institute. If you have any questions, please contact Annie Ransom aransom@pleasantvalleysd.org
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of University Preparation Charter School at CSUCI.
Report Abuse
Forms
