STEM Conference Spring 2023 - Moderator Registration Form
This form is to gather information about undergraduate student volunteers who are interested in being Zoom room moderators for the upcoming STEM Conference. 

The conference is from March 29 - 31 (1 - 4 p.m.), so please be as open as possible about your availability so we can set you up to moderate at the best times.

Moderators will be required to provide contact information and will need to join GroupMe to stay up to date on events pertaining to the conference.
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Email *
Full Name
GSU Student Email (@student.gsu.edu)
Phone Number (e.g 333-333-3333)

What is your organizational affiliation?
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What is your campus affiliation?
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Please select ALL dates and times you are willing to volunteer.
1 pm - 2 pm
2 pm - 3 pm
3 pm - 4 pm
Wednesday (03/29)
Thursday (03/30)
Friday (03/31)
Any special comments regarding your availability (e.g "Likely to change" or "might have worked at XYZ")
By signing your name below, you consent to the conditions that USRS must be notified through email by March 27 (usrsgsu@gmail.com) if you are unable to attend the conference.
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