Please provide the following information:

First Name
Last Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Contact Number
E-mail (required)

Major?

(none) Aerospace Chemical Civil/Environmental Electrical/Computer Industrial Materials Mechanical Nuclear Biomedical (other)

Class?

200920102011201220132014

Co-op Section?

None
Section 1
Section 2

GPA?

What other campus activities are you involved in?

Co-op employer/responsibilities (if applicable)?

What are your outside interests?

Why are you interested in the Engineering Ambassadors?

How did you hear about the Engineering Ambassadors?