Engineering Ambassadors Network Workshop Registration

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

You can use this form to register for Engineering Ambassadors Network workshops planned in academic year 2015 - 2016. Additional dates and locations will be added as workshops are confirmed.

So tell me, which Engineering Ambassador Workshop are you signing up for? *

Name (First and Last) *

School/Organization *

Department

Email *

Phone *

What's the best way to reach you? *

E-mail

Text

Call

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: *

Engineering Ambassador

Science Ambassador

Advisor

Other Other

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