Introduce a Girl to Engineering Registration 2018
!!!!!SHIFT B IS NOW ON A WAITLIST!!!!!!

ONE PERSON PER FORM, PLEASE!

If you would like to register a GROUP, please contact Kristen Kruger at 563-333-5701.

Girls (pre-school through 7th grade) and their guests are invited to come celebrate by learning how fun and exciting engineering and science can be through hands-on activities.

Tuesday, February 20 in the Rogalski Center Ballroom at St. Ambrose University. There is a cafeteria on the first floor (what seems like the basement) of the Rogalski Center. We will have light snacks available during the event, but if you would like something more meal-like, you may purchase them in the cafeteria.

You may park in the lot that is just north of the Rogalski Center after 3:30PM. Please check posted signs for any limitations.

Please come in comfortable clothes that could possibly get dirty! You and the girls will be doing a lot of walking and a lot of fun hands-on engineering and science activities!

In order to accommodate as many girls as possible, we are holding the event in TWO SHIFTS. The activities for each shift are identical, but you must sign up for and participate during one shift ONLY.

SHIFT A
2:30-3:00 Participant Check-In
3:00-5:00 Activities and demonstrations open

SHIFT B (WAITLIST)
5:00-5:30 Participate Check-in
5:30-7:30 Activities and demonstrations open

Which shift are you registering for? *
Participants are required to attend during the shift for which they registered ONLY.
Girl's First Name *
Your answer
Girl's Last Name *
Your answer
Parent's Name *
Your answer
Parent's Email Address *
Your answer
Girl's School *
Your answer
Girl's Grade *
Your answer
Girl's Age *
Your answer
Number of adults who will be with the participant? *
There are no volunteers or guides to take students around to the activities, so parents, counselors, or teachers are expected to remain with students during the event.
Your answer
Would you like to receive emails from SAU Engineering about upcoming events? *
Would you like to be included on the SAU mailing list for university promotions? *
Girl's Street Address
Your answer
Girl's City, State, Zip
Your answer
Would you like to purchase an Introduce A Girl to Engineering T-shirt for $10?
Shirts will be available for purchase (and you get to watch them being made!) on site, but this will help us get a general idea of the numbers needed.
If so, what size?
How did you hear about this event? *
Participant Agreement
In each of the last three years more than 250 girls were present at the event along with their parents and teachers. We do strive to make everything safe and fun for everyone, but we ask that you help us with this by being safe, courteous, and patient.

In addition, there will be newspaper and TV media present so photographs will be taken. Because the large number of participants, it is not possible for St. Ambrose to exclude some participants from being photographed and taped.

I agree that we will not hold St. Ambrose University liable for lost or stolen items or injuries incurred during the Introduce a Girl to Engineering event. *
Parent's initials
Your answer
I give my permission for my child’s picture to be used in reports and for promotional purposes related to this and future engineering at SAU events. *
Parent's initials
Your answer
Support for Introduce a Girl to Engineering is provided by
Teacher Education Program future STEM teachers
ebeam Technologies
SAU IEEE Women in Engineering Affinity Group
Exelon
Girl Scouts of Eastern Iowa and Western Illinois
US Army Corps of Engineers
FTC 12863 Flourish & Bots
FIRST Tech Challenge
Cobham
John Deere
SWE Quad City / Muscatine Section
SAU Chemistry
ATEEC
Quad City Botanical Center
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