SHPE REGION 5: SHPEtinas Virtual Conference 2021
Fill out the form below to register for this conference. After you've submitted the registration, you'll receive the event schedule to the email you have provided. Conference will be held in February 20th
Are you ...
*
Presenting
Attending
Both
Please specify if you are presenting and/or attending the conference.
Name
*
First Name
Last Name
E-mail
*
Pronouns
i.e. she/her
Gender
i.e. female
Race and Ethnicity
American Indian or Alaska Native
Asian
Black and African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Cultural Background
i.e. Mexican
Chapter
*
Please enter full university or professional chapter name, no acronyms. i.e not UTRGV, please type University of Texas Rio Grande Valley. If you are not part of a SHPE Chapter, please type N/A
Back
Next
Occupation
*
Professional
Graduate
Undergraduate
Academia
Major/Focus
*
i.e if you are a Computer Engineering student, type "Computer Engineering" or if you work in Project Management, type "Project Management"
Submit
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm