Registration

Participant InformationFirst Name:

Last Name:

Email Address:

Confirm Email Address:

Institution or Company:

Department (if applicable):

Institution Type:

Academic Government Lab Commercial

Participant (check all that apply):
Academic Faculty
Government Employee
Industrial User
Industrial User - Small business (<500 employees)
Undergraduate Student
Graduate Student
Student (other than graduate or undergraduate)
Other (please specify)

For Students: What is your major field of study?

Registration Questions
1. Please provide a brief description of your interests in nanoscience/technology. Describe your current interactions with NNCI facilities, services and staff.

2. What are your expectations for this meeting? Are there particular topics related to NNCI that you would like to learn more about?

Programmatic AccommodationsWe are committed to providing universal access to our programming and supporting special accommodation requests to the best of our ability. Please check the box below if you would like a member of the workshop staff to follow up with you to assist with accommodations that support your needs. Advance notice is necessary to arrange accommodation requests.

Please have a staff member follow up with me.

DemographicsNSF is committed to preparing a diverse, globally engaged science, technology, engineering, and mathematics (STEM) workforce, and to broaden participation from underrepresented groups and diverse institutions across all geographical regions in all NSF activities. To help us gauge participation in this event, please consider providing the following voluntary information:

Gender:

Male
Female
I do not self-identify as either male or female
I prefer not to answer

Ethnicity (choose one):

Hispanic or Latino
Not Hispanic or Latino
I prefer not to answer

Race (select one or more):
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
I prefer not to answer

Disability status (select one or more):
Hearing Impairment
Visual Impairment
Mobility/Orthopedic Impairment
Other
None
I prefer not to answer

Research Discipline (select all that apply):
Geology/Earth
Chemistry
Electronics
Educational Lab Use
Life Sciences
Materials
Medicine
MEMS/Mechanical Eng.
Optics
Physics
Process
Other reserach
If other, please describe:

Meeting Product Release and Code of Conduct

In confirming my registration for this meeting, I agree to receive a follow up email after the event. I also agree that any audio recording or images (still or video) made of me during the event may be used on the Montana Nanotechnology website, in printed project publications, and in materials developed by the project. I further agree that my contributions to creative works that emerge from event activities (e.g., discussions during the webinar, summaries of group discussion, etc.) may be used for development of future webinar/workshop materials, for scholarly reports, and for promotion of the project. Attribution for original contributions will be made whenever possible.

I also acknowledge that I have reviewed and will follow SERC's Code of Professional Conduct (opens in a new window) throughout the duration of my participation.

2023 NNCI Virtual Workshop Registration

April 5-6, 2023 Online