2024 Industry Day Attendee Registration Form UCSC Industry Day Attendee Registration Form First Name * Last Name * UCSC Email * Non-UCSC Email * Contact Phone Number (Lab Phone) What is your Lab’s Website/URL? * If your lab does not have a website, please provide your Department website. What is your career level? * Undergraduate StudentGraduate StudentPostdoctoral ResearcherFacultyStaff What is your highest degree completed? * High School (or GED)Associates (A.A, A.S)Bachelors (B.A., B.S.)Masters (M.A, M.S.)Doctorate (M.D., J.D., Ph.D.)Other What is your highest degree completed? What is your Department? * Applied MathematicsAstronomy and AstrophysicsBiomolecular EngineeringChemistryComputer Science and EngineeringEarth and Planetary SciencesEcology and Evolutionary BiologyElectrical and Computer EngineeringMathematicsMicrobiology and Environmental ToxicologyMolecular, Cell, and Developmental BiologyOcean SciencesPhysicsStatisticsOther What is your Department? What is the overall research focus of your lab? 0 of 100 max words Example: Cellular Interactions During Organogenesis and Tumorigenesis What is a current research project you are working on? * 0 of 100 max words Example: Notch/Robo regulated mechanisms governing cell fate acquisition What are the specific research aims you are currently working on in support of this research focus? * 0 of 100 max words Example: ROBO1 promotes differentiation by restricting the activation of one or more NOTCH receptors in AVPs Are you interested in a research collaboration with an industry partner/entity? * YesNoMaybe, let's discuss Are you interested in a non-research collaboration with an industry partner/entity? * YesNo Example: Core facility service/resource supplementation or strategic partnership Are you interested in pursuing career opportunities in industry? * YesNo Are you interested in an internship or shadowing opportunity in industry? * YesNo Are you interested in being contacted to discuss long-term needs for your research and not promotions * YesNo Are you interested in being contacted for promotions and other short-term offers? * YesNo What is the maximum number of times you like to be contacted in a given month by a company regardless of topic? * Less than once a monthOnce a monthBiweekly (once every 2 weeks)Weekly (one a week)More than once a week On a scale of 1-5, what is your level of influence or decision making ability for your lab overall? * 1 2 3 4 5 1: No Influence; 5: Total Control On a scale of 1-5, what is your level of influence or decision making ability for your lab’s research direction? * 1 2 3 4 5 1: No Influence; 5: Total Control On a scale of 1-5, what is your level of influence or decision making ability for your lab’s purchasing decisions? * 1 2 3 4 5 1: No Influence; 5: Total Control On a scale of 1-5, what is your level of influence or decision making ability for your lab entering into collaborations? * 1 2 3 4 5 1: No Influence; 5: Total Control If you are human, leave this field blank. This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply. Submit
