2025 NextGen Women in STEM™ – Harrisburg

Mentors and Career Opportunity Representatives Commitment Form

Saturday, October 4, 2025

9:00 AM to 3:00 PM (Eastern)

Commonwealth Charter Academy

One Innovation Way

Harrisburg, PA

Mentors and Career Opportunity Representatives

Commitment Form

NextGen - Harrisburg Mentors and Career Opportunity Representatives

Champion/Point of Contact First Name

First Name

Last Name

Organization

Contact Phone Number

Contact Email

Please provide the following for individuals who will attend and represent. We are inviting mentors and/or career opportunity representatives from your organizations.
Mentors commit to leading a group mentoring session. Please note that we are working to pull together a diverse slate of mentors and may not be able to accommodate all of those willing to participate.
Career Opportunity Representatives will staff a career table with real opportunities for your organization as possible internships or positions with your organization.

MENTORS

Please provide the following information for those who will attend as MENTORS:

MENTOR 1 FIRST AND LAST NAMES

MENTOR 1 TITLE

MENTOR 1 EMAIL ADDRESS

MENTOR 1 YEARS OF EXPERIENCE

MENTOR 1 STEM Focus/Background

Science

Technology

Engineering

Mathematics

Please email a short bio and headshot for MENTOR 1 to Yvonne Dunst at ydunst@stemupnetwork.org.

MENTOR 2 FIRST AND LAST NAMES

MENTOR 2 TITLE

MENTOR 2 EMAIL ADDRESS

MENTOR 2 YEARS OF EXPERIENCE

MENTOR 2 STEM Focus/Background

Science

Technology

Engineering

Mathematics

Please email a short bio and headshot for MENTOR 2 to Yvonne Dunst at ydunst@stemupnetwork.org.

DISPLAY TABLE AND CAREER OPPORTUNITY REPRESENTATIVES

Please complete the following fields if you wish to have a display table at the event.

DISPLAY TABLE REQUEST

Table size is 1.5' deep X 5' wide. No tablecloth provided.

Display Table Request

Standard - One (1) display table and two (2) chairs.

Special Request - Two (2) display tables, pushed together to a total surface size of 3' deep by 5' wide, and two (2) chairs.

Check this box if you need to be close to an electrical outlet. (Plan to bring your own 3 to 5-foot extension cord.)

CAREER OPPORTUNITY REPRESENTATIVE(S)

Please provide the following information for those who will staff your display table:

CAREER OPPORTUNITY REPRESENTATIVE 1 FIRST AND LAST NAMES

CAREER OPPORTUNITY REPRESENTATIVE 2 FIRST AND LAST NAMES

CAREER OPPORTUNITY REPRESENTATIVE 1 TITLE

CAREER OPPORTUNITY REPRESENTATIVE 2 TITLE

CAREER OPPORTUNITY REPRESENTATIVE 1 EMAIL ADDRESS

CAREER OPPORTUNITY REPRESENTATIVE 2 EMAIL ADDRESS

ADDITIONAL ATTENDEES

Please provide us with a list of additional attendees from your organization no later than Friday, September 19, 2025.

If you are human, leave this field blank.

We are excited to have your institution as part of this regional event designed to connect NextGen Women in STEM™ with each other and with opportunities in Central Pennsylvania!