Amazing World of Genes, Biology, and Me Registration Form

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Learn about biology in a fun way at the Amazing World of Genes, Biology, and Me workshop!
March 7th, 1-5 pm (EST) at the University of Michigan Dow building room 1013 (2300 Hayward St, Ann Arbor, MI)

AFTER FILLING OUT THIS FORM, PLEASE GO TO https://bit.ly/37TqAC0 TO PAY:
Suggested minimum donation: $25

100% of donations will go towards Dr. Shelly Flagel's research into addiction at the Department of Psychiatry, University of Michigan. Read more at: https://www.mircore.org/fundraiser/

Student Information

Student Full Name (First Last) *

School *

Grade *

4th

5th

6th

7th

8th

9th

Is the student able to bring a computer/tablet/phone to the workshop? *

Yes

Parent email *

Parent Cell Phone Number: (XXX)-XXX-XXXX *

Student email *

Where did you learn about this program? *

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