Student Services

Engineers' Day Registration
* Indicates required fields
*Is this an Individual Registration or a Group Registration:**	Individual Group

*First Name:**

*Last Name:**

*Address:**

*City:**

*State:**

*Zip Code:**

County:

*Phone Number:**

*Email:**

*High School/Organization Name:**

Total Number of Students Attending: (disabled if you select individual registration)*

Total Number of Chaperones Attedning: (disabled if you select individual registration)*

Anticipated Graduation Date: (disabled if you select group registration)*
2008 2009 2010 2011

Including Yourself, Number Of Persons Attending: (disabled if you select group registration)*

Have You Applied For Admission To Sinclair: (disabled if you select group registration)*	Yes No

Transportation Mode: (disabled if you select individual registration)*
Busses and quantity of vehicles
Cars/Vans and quantity of vehicles

*How Did You Hear About This Event:**
Newspaper Radio Invitation Mailer Guidance Counselor Admission Officer Friend or Family Other

444 West Third Street Dayton, Ohio 45402-1460 (800) 315-3000