Lifeology SciComm University Certificate Program Application

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Apply for Lifeology's SciComm University Certificate Program with this Google Form. By submitting an application, you are agreeing to pay the $60 program fee* and to participate for the entirety of the three-month program.

This program will begin on August 1, 2022.

*unless a program fee waiver is granted

Name *

Email *

Current job / position / role *

How many years have you been practicing science communication for public audiences? *

None

Less than 1 year

1-3 years

3-5 years

More than 5 years

Why are you interested in participating in Lifeology’s SciComm Uni Certification Program? *

What do you expect or hope to get out of this certificate program, in your own words? *

Please indicate the level of formal SciComm training you have received (including workshops, degree-granting programs or other certification programs): *

No training.

Some training.

Extensive training.

I have a university degree in science communication.

If you have received formal SciComm training, please name or describe the training(s):

Please indicate your agreement with the next two statements:

I feel confident in my public SciComm skills (for science communication to public audiences). *

Strongly disagree

Strongly agree

I am very knowledgable about the science of science communication. *

Strongly disagree

Strongly agree

How do you prefer that we communicate with you?

Slack

Either

Clear selection

Are you an artist and/or would you be willing to sketch/draw prompts in a collaborative assignment? *

Yes

No / I'd rather stick to writing only

What audiences do you communicate with? If you are currently not a practicing SciCommer, please tell us the audiences you are interested in communicating with. (e.g., kids, rural populations, etc.) Be as specific as possible so we can pair you up for program activities based on audience interests. *

Would you like to be considered for a program fee waiver or reduction? If yes, answer the next 3 questions. If no, please submit the form as is.

How much of the fee can you afford at this time?

$10

$20

$30

$40

$50

Clear selection

Please describe any economic hardships you may have at this time:

Why do you think you will benefit from this program and having the fee waived?

Submit

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