World Leaders in Education Program

Open House / Information Session Registration for Summer 2010 Term

NOTE: You should receive confirmation of this registration, within two business days. In addition, the location for the open house will be sent at a later date.

NAME:

EMAIL ADDRESS:

EMAIL ADDRESS: [RE-ENTER]

PHONE NUMBER:

HIGH SCHOOL CURRENTLY ATTENDING:

CITY: STATE:

YEAR:
Freshman
Sophomore
Junior
Senior
Other

DATE/TIME:
February 27; 3 PM - 5PM
March 20; 3 PM - 5PM
April 17; 3 PM - 5PM

DESIRED TRACK:
Nanotechnology
On-Demand Computing
Not Sure

TOTAL NUMBER OF PEOPLE ATTENDING, INCLUDING YOURSELF:

NOTE: You should receive confirmation of this registration, within two business days. In addition, the location information for the open house will be sent at a later date.