General Registration Information - All Registrants
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Create a Login Name: |
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Login Password: |
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Retype Password: |
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Individual Type - Robotics (Custom Field) |
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Prefix: |
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First Name: |
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Last Name: |
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Street Address: |
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City: |
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State: |
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Zip Code: |
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Your Email: |
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Your Secondary Email: |
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Your Phone: |
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Your Secondary Phone: |
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Parent's Email (If you are a parent, repeat your email here): |
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Parent's Cell Phone (If you are a parent, repeat your cell phone here): |
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Current Team Members Only - Students
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Student Interests (Select all that apply) |
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Graduation Year |
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Special Dietary Needs/Allergies |
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Can you legally drive a car? |
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Do you own a car? |
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How many passengers can you carry? |
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Have you taken Research and Design? |
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Parent 1 First Name: |
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Parent 1 Last Name: |
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Parent 2 First Name: |
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Parent 2 Last Name: |
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Parent Secondary Email: |
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Parent Secondary Cell Phone: |
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Adults Only - Parents, Mentors, Alumni
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Would you be interested in mentoring (Select all that apply)? |
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Please elaborate: preferred days of the week, times, areas of expertise, etc. |
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Are you willing to bring a meal during the build season? |
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