SPRING 2015 SESSION:

"Engineering the Frontiers of Medicine"
Tuesdays, March 31st - April 28th
6:00 to 8:00 pm
At Purdue West Lafayette Campus

Due to a significant amount of interest in this program (50+ applications each session!) we are not able to offer a space to all applicants. Priority is given to new applicants so more students have the opportunity to be exposed to engineering. If you are a previous participant, your name will be placed on our wait list and should a space become available, we will contact you.
Applications are due February 20th!

For complete information about the program please read the General Information Form.


Innovation 2 Reality (I2R) - Spring 2015 Application Form

**After you hit the submit button below, you should immediately see a message that indicates submission was successful and receive an email shortly thereafter which confirms submission. If you do not see this message, scroll through your application to see if any required entries are missing**

PARTICIPANT INFORMATION:


TO BE COMPLETED BY THE STUDENT:


PARENT INFORMATION:

Please submit an email address below that you use daily/regularly and would like WIEP to use in sending all important program information. If you do not have access to email, please call Sue at 765-496-7442 to discuss options.

EMERGENCY CONTACT INFORMATION:


This activity is free to attend. To complete your registration we require that, with your child, you read the Guidelines Agreement and sign below.

Click here to view the Guidelines Agreement. (Right click-> open in a new tab)


Click here to view the Photo Waiver. (Right click-> Open in a new tab)


:: Once admission decisions are made, all applicants will be notified of acceptance or wait listed by: March 6th, 2015 ::

CANCELLATION POLICY

Due to limited space, if at any time after you have applied, you decide you cannot attend please contact Sue Bayley at 765-496-7442 or sbayley@purdue.edu as soon as possible.

**When you hit the "submit" button below you should immediately see a message that indicates submission was successful, and receive a confirmation e-mail. If you do not see this message, scroll through your application to see if any required entries are missing. Thank you!**