PATHS Engineering Literacy Workshop Registration Form Museum of Science, June 14 5-6:30 pm

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Thank you for your interest in a Partners Aligned to Heighten Broad Participation in STEM (PATHS) Workshop. We are a coalition of partner organizations across MA, formed by minority serving institutions, UMASS Boston and BHCC, and funded by NASA, to address racial equity in STEM and contribute to a more diverse NASA workforce. We are working together to build a supportive culture that will broaden participation in Massachusetts and ensure multiple pathways for engineering students to succeed. We are offering many workshops to help students and mentors break down barriers and find a pathway to success that is right for them.

Please fill out the following questions to complete your workshop registration. All information that you provide will remain confidential. Your contact information may be used by PATHS to promote future events and seek additional feedback about your experience.

We are asking for your demographic information. While not required this information will help PATHS track our progress as we work to achieve our goal of broadening participation in STEM, engineering, and NASA-related careers. We are asking detailed demographic questions so that we may be specific in describing the groups that we engage and avoid lumping groups that have been historically marginalized into larger monolithic categories. We aim to support groups who are underrepresented in STEM. We define this as populations whose representation in STEM education or employment is smaller than their representation in the US population.

If you have any questions, about the workshop or about how the data will be used, please contact Aimee Bonanno at aimee.bonanno@umb.edu.

Email *

Name (first and last) *

Have you previously attended a PATHS event?

Yes

I'm not sure

This event will be at the Museum of Science. We will reimburse parking costs. Please let us know how you plan to arrive.

By car, will need parking pass validation

By train

I'm not sure

Other:

Are you: *

High school student

Community College student

Undergraduate student at a 4 year school

Graduate student

Post-graduate student

Professional in Engineering or other STEM field?

Higher Education faculty or staff

Other:

Required

With what school or organization are you affiliated?

Which of the following best describes your gender identity?

Female

Male

Non-binary

Trans female

Trans male

Prefer to self identify

Prefer not to answer

Other:

Clear selection

Are you Mexican, Puerto Rican, Cuban, Dominican, Central or South American, Spanish, or some other Spanish, Hispanic, or Latino group?

I am not Spanish, Hispanic, or Latino

Mexican

Puerto Rican

Cuban

Dominican

Central American

South American

Spanish

Some other Hispanic or Latino group

From multiple Spanish, Hispanic, or Latino groups

Clear selection

Are you Asian, Black or African-American, Native American, Native Alaskan, Native Hawaiian, other Pacific islander, White, or some other race?

Asian

Black or African American

Native American

Native Alaskan

Native Hawaiian

Other Pacific Islander

White

From multiple races

Prefer not to answer

Other:

How do you self identify your race or ethnicity? For example, Are you Japanese, Filipino, or Vietnamese? Are you Ethiopian, Nigerian, Somali, or Jamaican? What is your tribal affiliation, band, clan, or nation? Anything else?

Are you (or will you be) a first generation college student?

Yes

Clear selection

Have you ever served in any branch of the United States military?

Yes

Clear selection

Are you a person living with a disability?

Yes

Clear selection

Please let us know if you need any accommodations for the workshop. We will do our best to help you fully participate.

Send me a copy of my responses.

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