Registration Form

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Registration Form

The Women in Engineering Program, in partnership with the Keystone Program, is excited to offer an online summer program geared toward high school-aged women who are interested in engineering.

2020 Virtual Summer Program: How Can Data Predict What is Next?

To fully register, you must:

1. Complete the registration questions below.

2. Process the full payment of $450 (you will be redirected to the payment portal upon submission of this form)

*If you wish to be considered for a scholarship based on financial need, please fully complete this registration form and then email Becky at rzonies@umd.edu.

3. Complete and submit the waiver to Becky at rzonies@umd.edu. (waiver: https://eng.umd.edu/sites/clark.umd.edu/files/FINAL%20Participation-Agreement-and-Waiver-Online-Platform-.docx_0.pdf)

Your registration will not be complete until you have finalized all three steps (Registration, Payment, Waiver)

Participant First Name *

Participant Last Name *

Participant Email Address *

Date of Birth *

YYYY

City *

State/Providence *

Zip/Postal Code *

Grade entering in Fall 2020 *

9th

10th

11th

12th

College/University

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