Penn State WEPO 2008 Registration Form 

Women in Engineering Program Orientation

August 20-22, 2008

Early Arrival/Residence Hall Early Check-In:
I plan to move my belongings in early to University Park Residence Halls on August 20th.
I do not plan on moving my belongings in early to the Residence Halls OR I am a Commonwealth Campus student.
First Name:  Last Name:
PSU ID Number:   (e.g., 912345678)
Preferred Name (if other than given name) 
Age             Birthday: Month       Day  
Address:
City:       State:     Zip: 
Country (if other than USA):
Home Phone: -      Cell Phone: -
E-mail:
High School:

Select All That Apply [To enable coordination with these orientation programs]:
International Student Schreyer's Honors College ROTC Commonwealth Campus Student None
Name of Parent(s) and/or Guardian(s):
Emergency Contacts (Please fill out completely):
Contact 1 Contact 2
First Name
 Last Name
 First Name
 Last Name
Relationship to you
 City/State
 Relationship to you
 City/State
Day Phone
 Evening Phone
 Day Phone
 Evening Phone
PSU Campus Location in Fall 2008:
Preferred Major (including undecided): 
Note: Environmental is a minor at Penn State and can be combined with several majors (e.g. chemical, civil, etc.).
I have created my own web page [please enter URL:]
T-Shirt Size:    Small     Medium    Large     X-Large
Dietary Restrictions (i.e.. Vegetarian, no red meat, food allergies, etc):  
(less than 255 characters)
Special Needs/Handicaps: 
 
(less than 255 characters)
Hobbies: 
 
(less than 255 characters)
Entering Penn State: Summer 2008  Fall 2008

I have mailed the $100 registration fee* separately to the WEP Office. 
 

*Financial aid is available. Eligibility is based on need and FAFSA information.

(Please make checks payable to The Pennsylvania State University; 
include participant PSU ID number in the memo line.) 

Send payment to:
Women in Engineering WEPO '08
208 Hammond Building
University Park, PA 16802

For more information contact:
Cheryl Knobloch, Associate Director
Women in Engineering Program
814-863-1080