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AWE Sleeping Bag Weekend Registration

Registration Deadline: Due to an overwhelming response, we are currently only accepting registration for our waiting list. Please register for the waiting list by October 29,2012. We will contact you if we are able to provide a space for you.

Contact Information
First Name
Last Name
Street Address
City
State
Zip Code
Home Phone Number
Cell Phone Number (if applicable)
Email Address
Parent or Guardian Name
Parent or Guardian Phone

Academic Information
What fields of Engineering interest you the most? Check all that apply.

Bioengineering
Chemical and Biomolecular Engineering
Computer and Information Science
Electrical and Systems Engineering
Material Science and Engineering
Mechanical Engineering

Year in School
Graduation Year
GPA (indicate scale Ex. 3.8/4.0, 97/100, etc)
High School Name
What type of school do you attend?

Public
Parochial
Private
Home Schooled
Charter
High School Counselor
Counselor Phone
Counselor Email
Test Scores: Indicate your highest score achieved in each test category.
Enter N/A if you do not have a score to report.
PSAT Math
PSAT Verbal
SAT Math
SAT Critial Writing
ACT Math
ACT Science Reasoning
ACT Composite
Junior Year Math & Science Courses: Where appropriate, indicate the level of each course - AP, IB, Honors, Regents, Dual-Enroll)

Senior Year Math & Science Courses: Where appropriate, indicate the level of each course - AP, IB, Honors, Regents, Dual-Enroll)

Have you ever visited Penn or attended a Penn program?
If yes, list the date of your visit(s) and/or the name(s) of the program(s) you attended.

How did you learn about the AWE Program? Check all that apply.

Email
Brochure/Poster
Teacher
Counselor
Internet
Penn Admissions Counselor
Other
If other, please specify:

Additional Information
Racial/Ethnic Group (optional)

White, non-Hispanic
Hispanic
Black, non-Hispanic
Native American
Asian or Pacific Islander
Other
If other, please specify:

Dietary Restrictions
Any allergies we should know about?
Additional questions or comments.



Questions? Contact Michele Grab at 215-573-6487 or mgrab@seas.upenn.edu