2023 61st Annual QCESC STEM Celebration Registration

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The event is on Thursday, February 23rd, 2022 at The Bend Event Center, 1910 Bend Blvd, East Moline, IL. A social will start at 5:00 PM with dinner at 6:00 PM. Our keynote speaker will be Syed Mubeen, Director, Syed Mubeen Research Group and Associate Professor, Department of Chemical and Biochemical Engineering, University of Iowa and Chief Scientific Officer, SunHydrogen Inc.

More details can be found at https://qcesc.org/stem-celebration/

Everyone is invited to attend this annual premier event to network, celebrate, and showcase the great Science, Technology, Engineering and Math (STEM) Professionals and STEM educators in the Quad Cities region. The event is being held during Engineer Week (E-week).

You can register up to 8 people with this form. You must fill out all of the mandatory fields as indicated by a * symbol at the end of the field name (i.e. Name *) for the form to be saved and submitted. If you properly fill out the form and submit, you should see a message that says "Thanks - Your response has been recorded and e-mailed to the QCESC. If you don't see this message, you need to update or add missing information which will be highlighted on the form in red color.

After successfully submitting your registration, you will be automatically linked to a site to pay on-line using a credit card or PayPal: https://qcesc.org/stem-celebration-payment-page/. A confirmation of what you submitted will be e-mailed back to you automatically after you successfully submit the form.

Name badges will be created based on the names and information typed into the form.

The information you submit will only be used by the QCESC and will not be redistributed or sold.

If you have questions or need further Information, please contact one of our officers: http://qcesc.org/board-of-directors/

Refund Policy: Registrations are non-refundable unless the event is forced to be virtual due to COVID restrictions. If for some reason you're unable to attend you may give your reserved spot to someone else.

Email *

Contact Information for Person Submitting Registration Form

Your First Name *

(example John)

Your Last Name *

(Example Smith)

Phone Number *

(Form XXX-XXX-XXXX) Will only be used if we need contact you and are unable to by e-mail.

Total Number of People You Are Registering with this Form *

If more than 1 attendee, you'll be prompted for other attendee information after clicking next. If trying to register more than 8, you'll have to submit a second form

Total $ Amount Due *

($50 per person for adults, $35 for Full-Time Students, $0 Special Guests with prior QCESC board member approval)

How Do You Plan to Pay? *

Choice One

Pay On-line

Mail in Check Prior to Celebration to: QCESC, Box 1166, Bettendorf, IA 52722-0020

Comments or Questions

If you have any additional comments or questions, please add them to the comment box below including any special dietary restrictions.

Registration - Person 1

Fill out information for each person attending, up to 8 total

First Name *

Last Name *

Society Currently Belong To, If Any (IEEE, SAME, SWE, Etc.)

Note: Not required to belong to a society to attend Celebration

Employer, or School If Full-time Student

Cost *

$50 - Adult

$35 - Full-time Student with ID

$0 - Special Guest (Must Be Pre-Approved By QCESC Board Member)

$0 - Guest from Sponsoring Company (Must enter Employer Above)

Meal Selection *

Parmesan Crusted Sirloin - Garlic and Parmesan Crust finished with Bistro Herb Butter

Grilled Chicken Breast - Finished with a Honey Bourbon Sauce

Oven Roasted Salmon Fillet - Finished with Braised Leak Lemon Cream

Vegan/Vegetarian (Describe further in "Dietary Restrictions")

Dietary Restrictions

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