School Participation Form

Please complete the following form to register your school for the 16th Annual NCSSSMST Student Research Symposium at Penn.

By submitting this form, you are securing a place for one chaperone and up to two students from your school at the June symposium. If you are interested in bringing more than two students to the symposium, please indicate that below, and you will be notified if extra space becomes available.

Only heads of NCSSSMST member schools are allowed to register for the symposium. Parents and students may not register.

All fields are mandatory.

School Information

School Name:

School Address:

School City:

State:     Zip Code:

School Phone:

School Fax:

Teacher/Sponsor Information

The teacher/sponsor will receive all e-mail communication regarding the Symposium and be expected to submit the required forms according to the schedule on this website.

As the teacher/sponsor, add to your e-mail address book to ensure you receive e-mail communications.

Title: (Dr, Mr, Mrs, Ms, etc)

First Name:

Last Name:



Home Phone:

Number of students you would like to bring:
(note: this is for planning purposes and is no guarantee of the number of students your school can bring.)

Upon submitting this form, you will receive an e-mail with a 4-digit registration ID code. Keep this code for your records, as you will be asked for it on every subsequent Symposium registration form.

If you have questions about the form on this site, please e-mail Katharine Daulton at