2024 GEARs Registration

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Email *

What is your name?

Institution

Address

Emergency Contact Person, Relation, and Phone Number

Your phone number

Degree program and anticipated graduation date

Any dietary restrictions for provided meals?

I would be interested in sharing lodging expenses with other participants, please help facilitate this. I consent for my contact information to be shared with other students to facilitate this.

Yes

I have already planned a roommate

Clear selection

I plan on

Driving

Flying

Other:

Clear selection

Why are you interested in this workshop? What do you hope to get from it?

What sensors/topics are of specific interest to you?

My knowledge of electronics is...

Something about electrons

I'm comfortable designing my own circuits

Clear selection

When it comes to making mechanical things I'm...

Not sure which end of the screwdriver to pickup

Ready to weld up a masterpiece

Clear selection

Programming (any language) is

Foreign to me

Easier than writing a complete sentence

Clear selection

Weather permitting, we may be able to offer sunset plane rides over Siloam. Are you interested in an airplane ride?

Yes

Clear selection

We plan on having a mixer/short poster session so everyone gets to see what you're working on. Can you bring a poster on your research? (Reuse of a conference poster is fine!)

Yes

Clear selection

T-Shirt Size

XXL

Other:

Clear selection

I understand and will provide a check or credit card payment for the workshop fee in the amount of $750 and will provide my own travel, lodging, and meal expenses. I will sign the hold harmless agreement/liability waiver before participating in the workshop.

Agree

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