University of Hawai`i at Manoa
College of Engineering

Engineering Day

Saturday, September 25, 2004
8:30 a.m. - 1:00 p.m.

Registration Form

Deadline: September 15, 2004

Name of Student:

(Last name, First name, Middle initial)

Name of Parent(s) or Guest(s) Who Will Be Attending:

Address:

(include City/State/Zip)

Day Phone:

Evening Phone:

Email address:

School:

Grade Level:

10th 11th 12th

Advisor/Counselor Name:

Teacher(s) Name:

What teacher(s) have been most influential and helpful in your career planning?

Please check all that apply:

I am able to attend Engineering Day on September 25, 2004:

I will also attend the lunch with faculty & students

Total number of people attending lunch:

Please send me a complimentary parking pass

I am interested in the following areas:

Civil & Environmental Engineering
Electrical Engineering
Mechanical Engineering
Interested in all areas

I am not able to attend but would like:

Information sent to me
Visit the College of Engineering at a later date

Deadline: September 15, 2004