Discover Engineering Days - Registration

Discover Engineering Days Registration

Please indicate which day you want to attend *

I am a: *

If Other, please specify:

Teacher/Parent First Name *

Teacher/Parent Last Name *

If you selected "teacher", what subject(s) do you teach? *

School name *

Street Address *

City *

State *

Zip Code *

Cell Phone *

Email Address *

Grade levels of your students *

6th

7th

8th

other (note this event is for 6th-8th grade only)

Total number of students attending (max of 60 per school) *

Please list the names of all students

Total number of teachers/parents/chaperones attending (must bring at least 1 per 20 students)

Please list the names of all teachers/parents/chaperones:

Will you need parking?

Bus

Van

Not sure yet

How many buses?

Comments or special needs?

Leave this field blank

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