Seminar Application

Please fill out this application and the Postdoctoral Survey.

Once your application is received, we will ask your adviser to fill out a brief online recommendation form.

Your E-Mail Address (Required)

first name (Required)

last name (Required)

daytime phone number (area code first) (Required)

current institution (Required)

UW Madison

UW Milwaukee

current department (Required)

research adviser's name (Required)

research adviser's email address (Required)

seminar title (Required)

seminar abstract (Required)

Study Title: Advancing Women in Science and Engineering in the University of Wisconsin System

Dr. Erin Winterrowd, of the Department of Psychology, at the University of Wisconsin Oshkosh is conducting a study of the effectiveness of a seminar program for female post- doctoral scholars in Science, Technology, Engineering, and Math (STEM) fields. Your participation in this study would be greatly appreciated and will assist in making recommendations regarding training and mentoring of women in these fields. As part of this study, please fill out the linked online survey. There are questions related to your interest in and knowledge of academic positions at Primarily Undergraduate Institutions (PUIs). Additionally, you will be asked to evaluate the seminar program following its completion. Please note that this study is voluntary and not required to participate in the UW Women and Science Seminar Program. Although this question could be studied by just observing your participation in the program, asking you directly about your knowledge and experiences will provide more accurate information. There are no anticipated risks to your participation in the study, other than the inconvenience of extra time require for you to answer the questionnaire. Participation in this study may not benefit you directly. The information you provide in the questionnaire will be recorded in anonymous form. Information about you will not be released to anyone or in a way that could identify you. If you want to withdraw from the study at any time, you may do so without penalty. The information collected from you up to that point would be destroyed if you so desire. Once the study is completed, the results will be available to you. In the meantime, if you have any questions, please ask or contact: Dr. Erin Winterrowd Department of Psychology UW Oshkosh Oshkosh, WI 54901 Ph. 920/424-7175 If you have any concerns about your treatment as a participant in this study, please call or write: Chair, Institutional Review Board For Protection of Human Participants c/o Grants Office UW Oshkosh Oshkosh, WI 54901 Ph. 920/424-1415 Although the chairperson may ask for your name, all complaints are kept in confidence.

I have received an explanation of the study and agree to participate. I understand that my participation in this study is strictly voluntary.

your name

today's date

Please keep a copy of this consent form for your records.

This research project has been approved by the University of Wisconsin Oshkosh IRB for Protection of Human Participants for a 1-year period, valid until June 2012.

UW System Women & Science Program

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Seminar Application