TAP Think Tank Participation Interest Form

1
Enter your institutional email address and retrieve the verification code. This is for verification and confirmation purposes ONLY. Later in the form, we will ask you for an email address to send periodic updates to, if you would like them. If you do NOT work at an institution, enter your "regular" email address here.* This field is required.
example@example.com
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code?or
Receiving the email may take a few minutes, thank you for your patience!
2
What is your name?* This field is required.
First Name
Last Name
3
Why are you interested in joining The Science Haven's Communications Working Group?* This field is required.
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Large
Normal
Small
Ok
Ok
4
What field are you in? What are your affiliations?* This field is required.
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Large
Normal
Small
Ok
Ok
5
Share the link to your LinkedIn profile.Type n/a if not applicable.
6
Share the link to your Instagram profile.Type n/a if not applicable.
7
Share the link to your BlueSky profile.Type n/a if not applicable.
8
Share the link to your Twitter profile.Type n/a if not applicable.
9
Share the link to your TikTok profile.Type n/a if not applicable.
10
Share the link to your website.Type n/a if not applicable.
11
Where did you find out about this opportunity?* This field is required.
Twitter (X)
BlueSky
Threads
Facebook
TikTok
Instagram
Friend/Colleague
Other
12
Read the entire Code of Conduct Policy.
13
Read the entire Code of Conduct Policy & Confidentiality and Non-Disclosure Policy
14
Do you agree to abide by The Action Potential Code of Conduct Policy & Confidentiality and Non-Disclosure Policy?* This field is required.
I have read and agree to abide by The Action Potential Code of Conduct Policy & Non-Disclosure Policy.
15
Signature* This field is required.
Clear
16
Please type your name as appears in the above signature.* This field is required.
First Name
Last Name
17
Date* This field is required.
Date
Month
Day
Year
18
Enter the email address that you'd like to use for email updates.* This field is required.
example@example.com
Should be Empty: