NSF WomenTech Training Application, Hosted by MPICT, June 19-20, 2014

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Contact Information

This is the application for the WomenTech Educators Training, hosted by MPICT and led by Donna Milgram June 19-20, 2014 in the San Francisco Bay Area, CA. The training is currently full. However, there is still space on the waiting list, so if you are interested in attending please submit an application and you will be added to the waiting list. Thank you for applying. We will email you within 2 business days to confirm receipt of your application.

A letter of commitment from your dean is a required component of this application. Click here to download the letter (PDF).

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* 1. Last Name

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* 2. First Name

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* 3. Job Title

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* 4. Institution

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* 5. Email Address

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* 6. Phone Number

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* 7. Physical Address (City, State, ZIP)

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* 8. Dean name and title (If you are a dean, your supervisor):

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* 9. Dean email address:

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* 10. Select the appropriate travel stipend option. (Eligibility: Please note that only ICT faculty and administrators from the state of California are eligible for stipends.) If you apply for a stipend, you will receive an email notification with more information.

I am not eligible for a travel stipend.

I do not wish to apply for a travel stipend.

I would like to apply for the $50 stipend for educators whose college is within 70 miles of San Francisco.

I would like to apply for the $100 stipend and 2 paid hotel nights at the conference hotel for ICT educators whose college is between 71 and 250 miles of San Francisco.

I would like to apply for the $250 stipend and 2 paid hotel nights at the conference hotel for ICT educators whose college is between 251 and 500 miles of San Francisco.

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* 11. If you are applying as part of a team, please enter your team name here (e.g. Greenville Technical College Engineering Department or "ATE Project Name" team).

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* 12. Are you the key contact for your team? This person will be our main contact for your team during the application process.

Yes

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