HerStory Student Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

HerStory is an outreach event for young women who are curious about science. For more information, please visit our website: http://nuherstory.weebly.com/

The event will begin with a "Famous Women in Science" scavenger hunt around the Museum of Science and Industry, followed by a lunch (provided by the MSI). During the lunch, scientists and graduate students from Northwestern University and University of Chicago will speak with the students about their experiences and motivations in science and higher education.

When: Saturday, May 30th from ~10 am to 2:30 pm
Where: The Museum of Science and Industry (Transportation* and lunch provided)

*A bus will pick volunteers and attendees up from around Evanston and Chicago -- details on times and locations TBA.

The form below should be filled out by a parent/teacher/guardian to register a student.
Application Deadline: Friday, May 1st

For questions, email NUUCHerStory@gmail.com

--------------------------------------------

HerStory es un evento para mujeres jóvenes que tienen curiosidad por la ciencia.

El evento comenzará con una búsqueda del tesoro "Mujeres Famosas en la Historia de la Ciencia" alrededor del Museo de Ciencia e Industria, seguido de un almuerzo (proporcionado por el Museo). Durante el almuerzo, científicos y estudiantes de posgrado hablarán con las estudiantes sobre sus experiencias y motivaciones en la ciencia y educación superior.

Museum of Science and Industry (MSI)
sabado, el 8 de junio, 2019
10 am - 2:30 pm

* Un autobús recogerá voluntarios y asistentes de Evanston y Chicago: detalles sobre horarios y ubicaciones TBA.

Preguntas? Email a NUUCHerStory@gmail.com

Email *

Parent/teacher/guardian name (first and last) *

Relationship to student *

Parent

Teacher

Guardian

Other:

Parent/teacher/guardian phone number *

Best way to contact you *

Text

Phone call

Other:

Student name (first and last) *

Student email address (if applicable)

Student's school (or after school program) *

Student's grade *

Teacher's name (or after school program coordinator) *

Teacher's email address *

Please list any dietary restrictions

What mode of transportation will you be using on the way to the museum? *

I will be riding the provided bus

I will be arriving via my own form of transportation

If you are riding the bus, please tell us a location where you can be picked up, to help us arrange the bus stops (ie - uptown, Evanston, Lakeview, South Side, etc) -- You can be as broad or specific as you would like.

Please check any boxes that apply to the student *

Will be a first generation college student

Comes from an underrepresented background

Interested in learning more about college

Interested in science, careers in science, and science research

Required

Optional: In 5 sentences or less, tell us why the student wants to attend HerStory

Thank you for applying for HerStory! You will be notified on Friday, May 8th about your acceptance to HerStory. Please keep an eye out for an email, call, or text to notify you of your acceptance. If you are accepted, we ask that you please fill out the permission, photo release, and emergency contact forms. Here is a link to where you can find them: https://nuherstory.weebly.com/application.html

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 @u.northwestern.edu. Report Abuse

Forms