Women in the Sciences & Engineering Institute

Name:

PSU ID:

E-mail:

Department/Major:

College:

Campus:

Ethnicity:

Position/Status:

Gender:

How did you find out about WISE?	Friends Flyers Mailings Orientations Science/Engineering Advisor Science/Engineering Faculty Summer Camp Other

If you selected other to the previous question, please specify:

Do you feel any of the following barriers affect your success as a Penn State student?	Outside responsibilities (work/family) Lack of a support group Discrimination Isolation Sexual harassment Cost/Financial aid No barriers

Would you be interested in information on any of the following student organizations?	Association for Women in Sciences Graduate Women in Science Sigma Alpha Society of Women in Engineering Women in Information Sciences & Technology

Would you like to be more actively involved with WISE as a volunteer?	Yes No Undecided