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"Zoom a WISE Woman" Virtual Outreach - Teacher Request Form
Are you a teacher, school faculty member, or organization that is interested in having real scientists and engineers speak with your students about the work they do? We would LOVE to connect you with one of our WISE members through the "Zoom a WISE Woman" program! Please fill out this short survey and our Outreach Team will contact you to begin planning!
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Email
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Your email
Name (First Last)
*
Your answer
Please provide a second e-mail address as a back up.
Your answer
Please provide a phone number we can reach you at (optional)
Your answer
What school or group are you from?
*
Your answer
Where is your school or group located? (City, State)
*
Your answer
Approximate Grade Level(s) of students we would be working with
*
Your answer
Will you require someone who can speak another language other than English? If so, please specify.
Your answer
Do you have a topic/STEM unit/lesson you are specifically covering?
Your answer
Do you have any preference to what type of engineer/scientist volunteer we match you with (ex: chemist, biologist, mechanical engineer, aerospace engineer, etc)? We can't guarantee this, but we will try our best
Your answer
Would you be interested in a panel of scientists/engineers (more than one WiSE woman from a variety of content backgrounds)?
Yes
No
Other:
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Do you have specific or approximate dates/times in mind?
Your answer
Which of the following platforms does your group prefer to use? (Can select more than one)
Zoom
Microsoft Teams
Google Hangouts
Other:
Is there anything else you would like us to know about your request?
Your answer
Thank you for your interest in the Zoom a WiSE Woman program! Someone from our Outreach Team will contact you as soon as possible to begin planning a session with your students!
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