| CAMP Statewide Conference Form |
| Personal
Information *(Required Fields) |
*First Name |
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*Last Name |
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*Address |
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*City |
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State |
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Zip code |
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Hotel Accomodation/Meals |
*Major |
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*Class Level |
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*Ethnicity |
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*College |
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Faculty Mentor Information |
*Years
participating in CAMP |
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*Participation in CAMP events |
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*Doing Research on Campus |
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*If answered yes on previous question, list the name of the PI, the department of the PI, followed by the length of time doing rsearch (ie. Dr. smith, Dept. of Computer Science, 2 quarters) |
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*Funded by CAMP (stipends, travel, programs, including refreshments at events)
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