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Northwest Earth & Space Sciences Pathways
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Mini-Mission Registration Step 2
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Step
1
of 2
Lead Instructor Name
*
First
Last
Lead Instructor Email
*
Lead Instructor Phone
*
Which mini-mission will you lead?
*
James Webb Mini-Mission
ROADS on Icy Worlds Mini-Mission
Artemis ROADS Mini-Mission
We can offer additional training sessions for instructors that cannot attend the trainings above or need additional help. If you would like to request an additional training session, please describe your needs (e.g. which parts of the lessons would you like help with).
Please list and describe, if necessary, the organization were you will hold this Mini-Mission
*
Please provide the address for the organization where you will hold this mini-mission
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Does this organization cover insurance and liability for participants of your mini-mission?
*
Yes
No
I'm not sure
What is the starting date of your mini-mission?
*
What is the ending date of your mini-mission?
*
Please upload the Student Information Spreadsheet:
*
Click or drag a file to this area to upload.
Please upload a schedule that describes the dates and times of your mini-mission and a short description of the planned activities
*
Click or drag a file to this area to upload.
Would you like to request extra support, such as help running the scholarship session, a college student panel, or teaching assistant support? If you want NESSP to virtually visit your event, please give specific dates and times
Will you be requesting a stipend for a lead instructor?
*
Yes
No
Note, we are not able to provide stipends or payment of efforts to instructors that are already being paid for this work through another grant or organization.
Please Upload a Signed Lead Instructor W9 Form (Found: https://www.irs.gov/pub/irs-pdf/fw9.pdf)
*
Click or drag a file to this area to upload.
Please download, fill out, and upload a W9 form for the lead instructor. Please verify this form includes a complete address, social security number, and signature. Without all these items we will not be able to provide a stipend.
Will you be requesting a stipend for an assistant instructor?
*
Yes
No
Note, we are not able to provide stipends or payment of efforts to instructors that are already being paid for this work through another grant or organization.
Please Upload a Signed Assistant Instructor W9 Form (Found: https://www.irs.gov/pub/irs-pdf/fw9.pdf)
*
Click or drag a file to this area to upload.
Please download, fill out, and upload a W9 form for the lead instructor. Please verify this form includes a complete address, social security number, and signature. Without all these items we will not be able to provide a stipend.
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Announcements
NESSP News: Learn about the National Student Challenge and Upcoming Info Sessions – 🗓
Artemis ROADS II Mission Advisor registration is open! 🗓
NESSP NEWS: Back to School Opportunities! – September 12th, 2023 🗓