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Researcher interest form
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* Indicates required question
Your Name
*
Your answer
Your email address
*
Your answer
Your research website (if applicable)
Your answer
What is the name of your institution?
*
Your answer
Where is your institution located (city, state or country)
*
Your answer
What is your broad academic field?
*
Physical or Biological Sciences
Mathematics / Computer Science
English / Writing
Arts / Music
Social Sciences
Other:
Required
What is your specific academic field?
*
Your answer
Please include a weblink to a popular article, chapter, or other material that the students can read to learn about your work and ask questions in advance.
*
Your answer
For what level is this article appropriate? (Please check all that apply)
*
College / University
Upper high school (grades 11-12)
Lower high school (grades 9-10)
Middle school (grades 6-8)
Elementary School (grades 1-5)
Other:
Required
Would you like to share any ideas or requirements you might have for making this program with your schedule?
Your answer
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