Women in Science: Feedback

Your feedback will help us evaluate the impact of our Women in Science, Technology, Engineering & Mathematics programming. All information you provide will remain strictly confidential.

Complete the following feedback form and you will be added to our list to receive a free CD-set of our new series, The Sounds of Progress, available in summer 2008!

	Feedback Form
	Name:
	Address:
	Address 2:
	City:
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	Zip Code:
	Country:	United States Other
	*Email:
	Organization/Agency Affiliation :
	Title:
	Gender:	Female Male
	Age:	12 and under 13-18 19-35 36-65 over 65
Which series have you listened to? (check all that apply)
The Sounds of Progress: Part I The Sounds of Progress: Part II Powerful Signals: Part I Powerful Signals: Part II Her-Story: Then Her-Story: Now Tech Club Out Loud (available in Archives)
How do you plan to use the radio stories or other information on this website? (For example: Will you share the stories with students or family members? Will the information provided inform your design of a program for girls? Have the stories affected your own career aspirations? Has any of the information here contributed to your research into current STEM trends?

How did you hear about the Women in Science and Technology ON THE AIR! website? (For example: Did you hear a story or promotion on the radio? Did you see an article or advertisement in a publication? Did you come across the website while searching online? Did a friend or colleague inform you?)

Please let us know if you have suggestions for future Women in Science, Technology, Engineering & Mathematics radio programming or website content.

Additional comments?

May we contact you to let you know about future programs?
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If you have any other questions about this site, please contact WAMC's Women In Science at . Thank you.

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updated 5/08 by

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