Registration for STEM Education Day for Students on Wait List

First Name*

Last Name*

Email Address*

What is the grade level of the student attending STEM Education Day?*

What is the name of the school the student attends?*

What city and county does the student live in?

Will a parent or caregiver be attending STEM Education Day with the student?

If yes, what is the name(s) of the parent/caregiver attending?

What subject area most interests the student?

How did you hear about STEM Education Day?

How does the student identify?

What is the student's racial or ethnic background?

Is the student under 18 years old?*

If the student is under 18 years old, how old is the student?

Publicity Release for Persons Under 18

I give permission to North Carolina State University to make and to use for nonprofit educational purposes, audio and video recordings of my child during their participation in the STEM EDUCATION DAY at North Carolina State University. I understand that my child will not be compensated for any recordings that may be used in this capacity. I also give permission for photographs of my child to be used without compensation by NC State University for Web pages, advertising and/or promotional purposes.

Do you give NC State permission to use any photography, videography or audio of your child?*

Full Name of Parent/Caregiver

Full Name of Child

Publicity Release for Adults

I give permission to North Carolina State University to make, and to use for nonprofit educational purposes, audio and video recordings of me during my participation in STEM EDUCATION DAY at North Carolina State University. I understand that I will not be compensated for any recordings that may be used in this capacity. I also give permission for my photographs to be used without compensation by NC State University for Web pages, advertising and/or promotional purposes.

Do you give permission of NC State to use any photography, videography or audio of you?*

Full Name of Adult*

College of Education News

STEM Education Day Registration for Wait Listed Students

Publicity Release for Persons Under 18

Publicity Release for Adults