3rd Annual Midwest Conference for Undergraduate Women in Physics

Registration Information

Picture not available Registration for the 3rd Annual Midwest Conference for Undergraduate Women in Physics is currently open.

Registration information is collected for internal use only.

I. Contact Information

First Name

Last Name

University

Mailing Address

Phone Number [ex: (xxx) xxx-xxxx]

Email Address

Gender

Ethnicity

II. Education and Department Information

My field of study is:

My current status

My projected graduation date

Please list the courses you have taken in physics and related subjects

What is the highest physics degree offered at your University?

Your best estimation of the total number of faculty members in your department

Your best estimation of the total number of female members in your department

Is there a Women in Science and Engineering program or similar group on your campus?

If yes, how often do you attend events sponsored by this group?

For each of the following groups, how would you categorize the representation of females in your department?
Consider factors such as how vocal females are, how visible they are in the department operations, as well as numbers.

Overall:
Undergraduate Students:
Graduate Students:
Faculty:

III. Personal Statement

Did you attend any previous Conference for Undergraduate Women in Physics?

How did you hear about the conference?

If other, please specify

In a paragraph, explain why you would like to attend this conference and what you expect to get out of it.

IV. Research Presentation (optional)

Participants have the opportunity to give 10-15 minute oral presentations of research or present research in a poster session. Presenting research is optional and is not a factor for acceptance as a participant. Participants who present will be given guidelines for preparing their oral and poster presentations. The number of oral presentations may be limited.

If you're a faculty or staff member and are interested in presenting at the conference, please contact the conference organizers at wipconf@mps.ohio-state.edu

Would you like to present research that you have done as an undergraduate?

If you would like to present, please summarize your research topic:

V. Undergraduate Advisor

Please give the name and email address of your advisor or department chair. Your advisor will be sent an email requesting their endorsement of your participation in the conference.

Undergraduate Advisor

Email Address

VI. Estimated Travel Expenses

Travel grants are available for qualified participants. The amount awarded to each participant will depend on the total amount requested by all participants (no more than $100.00 per travel). The participants will be notified of the amount they have been awarded by early January. We request that you ask your home institutions for support before applying for aid.

My department is contributing to my travel expenses:
$

Method of Travel:

If other, please specify method of travel below:

Estimated Ticket Cost:
(if you will be travelling by plane, train or bus)

Please give exact ticket values if available. Good estimates for airfare can be obtained by going to online travel services such as Orbitz, Travelocity or Kayak.

If traveling by car, will you be the driver?

Distance driven

(round to the nearest mile)

If traveling by car but are not the driver, please enter the name and email address of the driver

Driver Full Name

Driver Email Address

VII. Accommodation Information

Accomodations will be provided for participants on Friday and Saturday evening, if required. There will be two participants per room. On-campus parking will be provided for local participants not staying at the hotel.
I would like accomodations for the following nights:

If you know someone else who is coming and would like to share a room, please enter their full name below

Meals will be provided from breakfast on Saturday through lunch on Sunday. Do you have any special dietary restrictions?

VIII. Notes

If you would like to clarify any of the above questions, please enter your notes below

Begin OSU masthead and toolbar

Begin main menu