JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Scientists Live Video Registration Form
Please complete this form to receive the links to 2020 and 2021 "Scientists Live" Career Series recordings.
One registration form per participating classroom, please. If you have any questions, feel free to contact one of us at
lori.wick@wisc.edu
,
deborah.harris@wisc.edu
or
amy.mitchell@wisc.edu
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Teacher's Name (first and last)
*
Your answer
School Name
*
Your answer
County
*
Crawford County
Lafayette County
Walworth County
Other
Mailing Address
*
Your answer
Phone Number
*
Your answer
Grade Level(s) viewing the videos
*
Your answer
What is the approximate number of students who will be viewing these videos?
*
Your answer
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of UW-Madison Google Workspace.
Report Abuse
Forms
