2017 EA Conference Registration

Thanks for your interest in attending an event with the Engineering Ambassadors Network. We can't wait to see you!

You can use this form to register for conferences or workshops planned in the 2017 - 18 academic year. Additional dates and locations will be added as events are confirmed.

So tell me, which Engineering Ambassadors event are you signing up for? *

First Name *

Last Name *

School/Organization *

Department

Email *

Phone *

Please provide the name of a person to contact in case of an emergency.

Name *

Cell Phone *

Relationship *

Please describe any dietary restrictions or special considerations.

Do you have any mobility considerations that may affect your ability to use stairs or walk short distances? *

Yes

No

I am an: *

Good job - you're a born registration form filler-outer! Just a few more questions...