Event Documentation Form

Event Documentation Form

Speaking of Science Louisiana
Speaking of Science is a National Science Foundation (NSF) funded program through the Louisiana EPSCoR program at the Louisiana Board of Regents for Higher Education (BoR). The NSF and the BoR are committed to providing equal opportunities for participation in its programs and promoting the full use of the nation's research resources. To aid in meeting these objectives, the NSF collects information on the gender, race, ethnicity, and disability status of individuals participating or served by NSF-sponsored activities. The Board of Regents must periodically report its progress in this area, including the Speaking of Science (SoS) program. Please help us collect this data by providing information regarding the SoS audience.
Event Information
Name of Sponsoring Organization*
Visiting Scientist Name*

First NameLast Name
Date Event Occurred*

MonthDayYear
Date
Presentation/Topic Title*
Attendance

School Attendance Data
This section is to be completed in the case a Speaking of Science event has been hosted on the campus of PK-12 Institution.

Enter K-12 Student Attendance Here (optional)

	American Indian or Alaska Native	Asian	Black or African American	Hispanic or Latino	Native Hawaiian or Pacific Islander	White, Not Hispanic or Latino	Students with Disabilities
Male
Female

Institutions of Higher Education Attendance Data
This section is to be completed in the case a Speaking of Science event has been hosted on the campus of an insitution of higher education.
Academic Research Institution Total Faculty Attendance
Academic Research Institution Total Student Attendance
Undergraduate Institution Total Faculty Attendance
Undergraduate Institution Total Student Attendance
Primarily Minority Serving Institution Faculty Attendance (HBCU etc.)
Primarily Minority Serving Institution Student Attendance (HBCU etc.)

Other Institutions Attendance Data
This section is to be completed in the case a Speaking of Science event has been hosted by a library, museum, or civic organization.
Total Number of People Present (required)

Enter Attendance Here (optional)

	American Indian or Alaska Native	Asian	Black or African American	Hispanic or Latino	Native Hawaiian or Pacific Islander	White, Not Hispanic or Latino	Students with Disabilities
Male
Female

Event Information