*Required Fields

*Who Are you? (Student, Parent, Educator, Guidance Counselor)

*First Name

*Last Name

*Student Grade (Junior, Senior)

*Name of School

*Name of Teacher/Guidance Counselor

*Home Address

*City

*State

*Zip

(One phone number is required)

*Home Phone Number (ex - 5555555555)

Cell Phone Number (ex - 5555555555)

*E-Mail

Worshops
Place numbers 1-5, with number 1 as your top preferece, in the boxes below. (1 being the most desired, 5 being the least)

 #1 Build It With SparkFun Electronics

 #2 Challenger

 #3 Who Done It? (CSI/Forensics Murder Mystery)

 #4 Heart Lab

 #5 YWIST; HerWorld Apprentice

 #6 Educators Only: The Ease of a College Education

For questions, please contact Sheila Scott at 303-280-7570 or email ywist@devry.edu