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“Girls will not succeed if they do not believe that they can succeed.”


- Beyond Bias and Barriers: Fufilling the Potential of Women in Academic Science and Engineering. Committee on Science, Engineering, and Public Policy. The National Academies Press, 2006

Mentoring Program
Coordinator Workshop

Registration Form

I wish to attend the training workshop offered at:
Lake Land Community College, April 24, 2009.


First Name

Last Name
Position/Title
Institution
Teaching Field
(if applicable)
E-mail Address
Work Address Line 1
Work Address Line 2
City
State
    Zip
Daytime Phone
Ext.
Alternate Phone
Ext.
Fax


You will receive a copy of your submission by email, but
you may want to print out a copy for your records before submitting.