Name
Local Address
City/State/Zip
Local Phone
E-mail

Degree you are working toward and expected completion date
Discipline (i.e., aerospace engineering, electrical engineering, etc.)
Hobbies
Home Address
Hometown/State/Zip
Home Phone

I am interested in volunteering as a [check one]

E-pen pal for a high school student
SWE committee member
Ms. Wizard Day coordinator
EYH assistant
EPICS participant

I'd like to learn more about service/learning projects that involve engineering.

Please state why you want to become a WEP volunteer.

Please list any pertinent lab/research experiences or expertise that you have had and could share with a prospective student or current engineering undergraduate.

In your opinion, what is the most important thing for a woman who wants to be an engineer to remember?

What is the best advice you could give to a prospective student or current engineering undergraduate.?

How soon would you be available to begin any volunteer activities?

Have you ever been a volunteer before? Yes No

If yes, please describe your activities and list the organizations you served.