Voices for Science-Workshop Preparation Form

Name*
First Last
Email*
Please list any dietary restrictions or food allergies.
Would you like to book your own travel to the workshop and be reimbursed, or have AGU book your travel for you?*
- Book my own travel and be reimbursed
- Have AGU book my travel
Travel*
By clicking this box, I acknowledge:
I am booking my own travel to and from Washington, DC, and that I understand that programming begins at 5pm on Monday, 30 March and ends at 4pm on Wednesday, 1 April.
If you want AGU to book your flight for you, what is your local departure airport?*
If you want AGU to book your flight for you, what is your full name as it appears on your ID?*
If you want AGU to book your flight for you, what travel preferences do you have for travel, if any?*
Include a short biography of 100 words or less here.*
Upload a headshot of yourself.*
Accepted file types: jpg, png.
Department Head (or equivalent) - Name*
First Last
Department Head (or equivalent) - Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Photo Release*
By checking this box, I agree to the below.
During the events of the 2020 Voices for Science Workshop, which will take place in Washington, DC on 30 March-1 April, the AGU may take photos and/or video for use in future: pamphlets, brochures, and informational booklets; at meetings, lectures, and workshops; in public presentations during meetings and other events; in promotional and educational videos; and on Web sites maintained by the AGU. I give the AGU permission to publish in print, electronic, or video format the likeness or image of myself. I release all claims against the AGU with respect to copyright ownership and publication including any claim for compensation related to use of the materials.
Name
This field is for validation purposes and should be left unchanged.