Santa Fe Community College Registration Part 1 Register Online at

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.