Registration Form
Joint Conference of
The American Society for Engineering Education - St. Lawrence Section
and
New York Cyber Security and Engineering Technology Association


2017 Conference Registration
April 21-22, 2017       University at Buffalo       Buffalo, New York







E-mail Address:
Password:

If you have not requested a password or don't remember your password, click here.




AFFILIATION

    ASEE             NYS ETA             Both ASEE & NYS ETA             Neither        

       


CONTACT INFORMATION

Saluation:
    Dr.           Professor           Mr.           Mrs.           Ms.           Miss      

Name:
    First:     Middle Initial:     Last:

Name to Appear on Badge:

Title:

School/Organization/Company:

Address:
    Address Line #1:
    Address Line #2:
    City:     State/Province:     ZIP/Postal Code:
    Phone Number (Day):

When will you be arriving?     Friday, April 21     Saturday, April 22    
Will you be attending the banquet?     Yes     No
Would you be interested in judging posters?     Yes     No    
Will a guest be attending the banquet?     Yes     No
    Name of Guest (if applicable):    

Registration Type: Early Registration
(before 4/1/17)
Regular Registration
Professional (Friday & Saturday) $130 $155
Professional (Saturday) $95 $115
Retiree $70  
Student (with Friday banquet) $60 $70
Student (without Friday banquet) $30 $40
Exhibitor
    Platinum ($1,000 and up)
    Gold ($500 and up)
    Silver ($250 and up)

 
Student Volunteer
      Registration required, meals included.
      Limited availability.
      Confirm with conference organizers (CSE-ASEE@cse.buffalo.edu)
No charge No charge
Banquet Preferences
    Chichken Saltambaca
    Mediteranian Salmon
    Roasted Vegetables
   


       
        Method of Payment:
    Check
    Check sent by my instituion with my name indicated.

Please make check payable to:
ASEE (Memo: St. Lawrence Section)

Send check to:
Jill Powell, Treasurer, ASEE St. Lawrence Section
103A Carpenter Hall, Cornell University
Ithaca, NY 14853
For early registration, checks MUST be received by 4/6/17