2019 Southwest Regionals Registration
Email address *
Email Address (Personal) *
Your answer
Do you need to renew your AIChE membership? (we can do it for you on the day of the conference) *
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
University *
Shirt Size *
Dietary Restrictions *
Do you need ADA accommodations? *
Emergency Contact (Name and Phone Number) *
Your answer
Where are you staying? *
Will you attend the student mixer on Friday, March 29th? *
Will you attend the student dinner on Saturday, March 30th? *
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