Manufacturing Academy
Registration
* Required Field
Name:
*
Address:
*
City:
*
State:
*
Zip Code:
*
Phone:
*
Email Address:
*
Birth Date:
*
Ethnic Group:
White
Black
American Indian
Asian
Hispanic
Native Hawaiian/Pacific Islander
Other
US Citizen:
Yes
No
Gender:
Male
Female
Please indicate any special needs below:
Adult Sessions
Please select which session you'd prefer to attend
May 19 - 22
May 27 - 30
Student Sessions
(High School Juniors or Seniors)
Please select which session you'd prefer to attend and also fill out the name of your high school and anticipated grad date:
June 16 - 19
June 23 - 26
High School:
Planned Graduation Date: