PVSTEMNet INFORMATION UPDATE

Other affiliation form

Name:  
Position
Email:   
Name of organization:
Type of organization: 
Address Line 1         
Address Line 2         
City/Town                

Size of Organization (# of employees):
1-50 50-100 over 100 over 500 over 1,000

Would your Organization be interested in working in any of the following areas?

career fair student internships working with Network in an advisory capacity
hosting site visits mentoring student employment/work study
teacher externships Other (specify)  

Are you interested in offering professional development programs for teachers
yes   What areas/grades?
no

Are you interested in hosting visits to your institution/organization
yes    Details
no

Are you interested in visiting schools to give talks, offer hands-on experiences, etc?
yes    Details
no

Describe new or noteworthy programs in support of improving STEM education offered by your organization. Include grade level(s) and subject(s).

Program contact: Name   Email Website

Are you currently a member of the network? yes no
Are you currently on the email list? yes no
Are you interested in attending Network meetings and becoming a more active member? yes no

Comments



Thank you!