Genetics Workshop Science Assessment Consent Form
Complete this form to register for the genetics workshop science assessment and review the participation acknowledgment before submitting.
Participant Information
Participant Name
*
First Name
Middle Name
Last Name
Email Address
*
example@example.com
Workshop Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Workshop Background and Assessment
Prior genetics knowledge level
*
None
Basic familiarity
Intermediate understanding
Advanced understanding
Other
Confidence going into the workshop
*
Not confident
1
2
3
4
5
6
7
8
9
Very confident
10
1 is Not confident, 10 is Very confident
Previous genetics or biology workshop experience
No prior workshop experience
Attended 1 workshop
Attended 2-3 workshops
Attended 4 or more workshops
Other
Workshop topics and skills assessment
*
Rows
No experience
Basic
Proficient
Advanced
DNA structure and function
1
2
3
4
Inheritance patterns
5
6
7
8
Interpreting genetic data
9
10
11
12
Lab safety and sample handling
13
14
15
16
Consent and Acknowledgment
I agree to participate in the genetics workshop science assessment and acknowledge the workshop materials and activities
*
I Agree
I Do Not Agree
Signature
*
Submit Form
Submit Form
Should be Empty: