Register – Engineering Club

Your Info

First Name *

Last Name *

Email Address *

Phone *

Session Info

Workshop Date *May 2nd – $80

Has your student attended an INSPIRE workshop previously? *YesNo

Student Info

First Name *

Last Name *

Student Grade *

Student Enrollment *My student is enrolled in the Lake Washington School District (LWSD)My student is enrolled in another district or homeschooled

Student Experience with 3D Design / 3D Printing *Lots of experienceSome experienceNo Experience

Student Experience with Circuitry / Programming *Lots of experienceSome experienceNo Experience

Emergency Contact InfoTo be contacted if the primary contact (above) can’t be reached.

Emergency Contact First Name *

Emergency Contact Last Name *

Emergency Contact Phone *

Special Requests / Extra Info

Select

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