FameLab 2015 Registration Form

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FameLab

®

Registration Form

Welcome to FameLab Greece – one of the components of the International FameLab: www.britishcouncil.gr

Please complete this form, which will not be seen by the judges before your audition.

Indicate which of the two qualifying round venues is more convenient for you by ticking the appropriate box:

Athens: Monday 2 March 2015

Τhessaloniki: Tuesday 3 March 2015

Firstly, some information about you:

Title: _______ Name: _____________________________________________________________

Email address: ____________________________________________________________________

Contact telephone: _________________________________ Your home postcode: _____________

Your home address: _______________________________________________________________

Your position and organisation: _______________________________________________________

What is your highest scientific or technical qualification? (Please specify e.g. BSc, MSc, PhD)

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Which scientific field/area of research do you work in? _____________________________________

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Please give us a short biography (approx.. 50 words)

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The United Kingdom’s international organisation for cultural relations and educational opportunities.

A registered charity: 209131 (England and Wales) SC037733 (Scotland).

How many years have you worked in the area of research? _________________________________

Is your work funded by an organisation? ________________________________________________

Approximately how many kilometres will you have to travel to attend the competition?

_________________________________________________________________________________

Secondly, some questions about FameLab:

1. How did you hear about FameLab?

2. Please explain why you have decided to enter the competition and what you hope to gain professionally and/or personally.

3. What scientific subject have you chosen for your presentation and why?

4. Please explain how you have researched and prepared the material for your presentation.

Thirdly, some questions about your previous science communication experience:

5. Not including FameLab, have you ever been involved in science communication activities aimed at non-specialist audiences (e.g. the public, school groups or families)?

Yes No Not sure

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6. Please indicate how many (if any) of the following science communication activities aimed at

non-specialist audiences (e.g. the public, school groups or families) you have been involved with during the last year:

Activity How many in the last year?

Lectures/presentations as part of your job

Lectures/presentations in addition to your job

Role model schemes

Science festivals

Open days/fun days

Activities at museums or science centres

Television

Radio

Science Writing

Other

Other

Other

Finally, some more questions about you:

7. We may want to contact you at a later date to ask your opinion of FameLab. Please indicate if you would be willing to be contacted in either or both of the following ways:

Email Telephone

8. We may want to use your e-mail address to send you details of British Council activities, services and events (including social events) which you may find of interest.

Yes, I would like to receive details of British Council activities, services and events.

9. Would you be happy for us to pass your details to science communication or media organisations that might be able to offer you other opportunities in these fields?

Yes, please. No, thanks.

10. Are you:

Male Female

11. Please indicate your age:

18 –20 21 –24 25 –34 35 –44 45+

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Disclaimer: The British Council and the competition venue are not liable for any loss or damage to property whilst at the event or travelling to the event, nor for personal injury or death unless d ue to the applicable party’s negligence.

Signed:

…………………………………………………………

Date:

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Please send the completed form by post, fax or email to:

Athens

Vangelis Kravvaritis

British Council

17 Kolonaki Square

106 73 Athens

Telephone 210 369 2361

Fax 210 361 4658

Email Vangelis.Kravvaritis@britishcouncil.gr

Thessaloniki

Chrysoula Melidou

British Council

PO Box 12004

541 01 Thessaloniki

Telephone 2310 378 314

Fax 2310 282 498

Email Chrysoula.Melidou@britishcouncil.gr

Deadline for receipt of registration forms: 28 February 2015 (23.59)

Thank you and good luck!

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