Registration Form
Join us for the St. Louis Graduate Women in Science (GWIS) Chapter's 1st annual research conference on Diverse Voices in STEM. Friday, March 6, 2020, 9 AM to 5 PM, UMSL North Campus, JC Penney 202. Continental breakfast, lunch, and afternoon snacks provided. The conference includes a mentoring luncheon, keynote address on networking, poster session, speaker panels, and professional development workshops. Registration is free for students and members of the St. Louis American Chemical Society Women Chemists Committee. Fees are $15 for GWIS members and $20 for non-GWIS members.

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What is your name and title (first name, middle initial, last name)? *
What is your University Affiliation, if applicable?
What is your academic status? *
What is your email address? *
What is your phone number? *
What is your Department affiliation? *
Another Department/College/Institute not listed above:
Are you a member of the St. Louis Chapter of Graduate Women in Science (GWIS)? *
Are you a member of the St. Louis American Chemical Society Women Chemists Committee (WCC)? *
What type of presentation are you proposing, if applicable? Check all formats you would like considered.
If you are submitting a presentation, what is the title of your presentation?
If you are submitting a presentation, list all authors of your presentation, in the order to be listed in the program (first, middle initial, last):
If you are submitting a presentation, please provide a 250 word abstract of your presentation.
Do you have any dietary restrictions? Select all that apply. *
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