Santa Fe Community College Registration Part 1 Register Online at
Transcripción
Santa Fe Community College Registration Part 1 Register Online at
Registration Part 1 Student Registration Form Please return this form to your school sponsor or via mail. You may also register online. Make checks payable to: EYH-‐ Santa Fe Student Name: _______________________________ Parent/Guardian Name: _______________________ Parent Email: ________________________________ Mailing Address: _____________________________ ____________________________________________ Phone Number: ______________________________ Cell Phone: __________________________________ q Yes, please send me a reminder email q Yes, please send me a reminder text School:______________________________________ Grade: ______________________________________ Tee Shirt Size ______________ (Adult Sizing) Demographics: q Native American q Hispanic q White q q q African American Asian Other: ___________ Please rank categories of interest by (1st, 2nd, 3rd choice) _____ General Science _____ Engineering/Technology _____ Mathematics/Computer Science _____ Medical/ Life Sciences _____ Physical Sciences _____ Other Interest: _____________________ How did you hear about the EYH conference? ____________________________________________ List any food allergies you have: ____________________________________________ Please indicate any special assistance/needs: ____________________________________________ Do you need financial assistance to cover the cost of registration? q Yes q No The Santa Fe EYH Conference is presented by the New Mexico Network for Women in Science and Engineering and the American Association of University Women- Santa Fe. Santa Fe EYH Conference 2015 A STEM Conference for Girls in 5th-8th Grades Register Online at: www.expandingyourhorizons.org/ conferences/Santa Fe/ Questions? Santa Fe EYH Chairs 2015: Lina Germann: [email protected] (505) 310-4122 Kate Binns: [email protected] (802) 578-3191 Inspiring young women to explore and pursue Science and Math careers. Saturday, September 19th, 2015 Santa Fe Community College 9:00 a.m. – 3:00 p.m. 6401 Richards Avenue Campus Center Hosted by Santa Fe Community College Many thanks to our co-sponsors including: Sandia National Laboratories, Los Alamos National Laboratory, Flow Science, Santa Fe Institute, Infinite Possibilities Fun as Santa Fe Community Foundation, and Santa Fe Alliance for Science. The Conference What is EYH? Expanding Your Horizons is a national organization encourages young women to pursue science, that technology, engineering, and mathematics (STEM) careers. The ultimate goal is to motivate girls to become innovative and creative thinkers ready to meet 21st century challenges. This year the Santa Fe EYH Conference will offer 150 girls in grades 5-8 a day long conference with handson workshops in STEM and related fields. In a fun, supportive environment girls meet peers who are also interested in STEM fields and learn from female scientifists in careers that may include crytopgraphy, earthquakes, water resources, robtoics, DNA, light and lasers, computer animation and emergency medicine. ¿Que es EYH? Expandiendo tues Horizontes (EYH por sus siglas en ingles) es una organizacion nacional que anima a las mujeres jóvenes a dedicarse a la ciencia, tecnología, ingeniería, y matemáticas (STEM). El objetivo final es motivar a las jóvenes a convertirse en pensadoras innovadores y creativas preparadas para enfrentar los desafíos del siglo 21. Este año la Conferencia EYH en Santa Fe ofrece a 150 las niñas de los grados 5 al 8 una conferencia de un día de duración con talleres práticos en STEMC y campos relacionados. En un ambiente divertido de chicas para chicas que estén interesadas en los campos de STEM, para aprender de mujeres científicas y otras profesionales en carreras futuras que pueden incluir criptografía, simología (terremotos), recursos del agua, robótica, el AND, luz y láser, ingeniería, animación por computación y medicina de emergencia. Registration General Information → Pre-registration for students is required → A free adult session is available for parents and teachers. Registration on-site. → Teachers and/or parents are not required to attend with their students. → Non-refundable student registration fee is $10.00. (A waiver is available upon request, see Registration Part 1) → Check-in between 8:00 a.m. and 8:45 a.m. Conference begins at 9:00 a.m. → Check-out between 2:30 and 3:00 p.m. at the Jemez Rooms To c onf irm a s p ot, regis t er by SEP TEM BE R 4 th ! Sp ace is lim it ed! Reg ist er n ow ! How to Register: → You may register online, via mail, or through a school sponsor. → T o register online visit: www.expandingyourhorizons.org/conferences/S anta Fe/ Please print and bring a release form to the conference. → To register via mail: detach and send form and $10 check payable to EYH-Santa Fe. (EYH-Santa Fe, c/o NMNWSE, PO Box 1360, Los Alamos, NM 87544) → If you have a school sponsor, you may return the registration form and payment to him/her. Registration Part 2 In order for my child to participate at the EYH conference, I agree as follows: Participant shall remain liable and hold EYHSanta Fe, NMNWSE, AAUW Santa Fe, and Santa Fe Community College harmless for any liability arising from their participation in the September 19th, 2015 Expanding Your Horizons Conference at Santa Fe Community College, except injury or damage that may occur because of sole negligence, or willful and wanton misconduct of Santa Fe Community College, its officers, agents, or employees. I give permission to use photos or videos that include my daughter for the purpose of publicizing and promoting future Expanding Your Horizons conferences. I understand that the images and recordings may be published in local newspapers, the Internet, or used in other marketing material promotions for the EYH conference. Names and other private information such as addresses, phone numbers, email or schools will NOT be published. __________________________ Signature of Parent/Guardian _________ Date __________________________ Printed Name *Cut off this panel and return with payment or financial assistance request.