First Name * Last Name * Middle Name Address * Phone * E-mail * E-mail Address: * Your current Academic year Have you taken or are you currently taking any Lab oriented courses? Yes No If ‘Yes’, please list these courses, and the institution where you have taken or are taking them. Have you had any experiences building electronic circuits? * Yes No If ‘Yes’, please tell us something about these experiences. Do you plan to pursue a career in Electrical Engineering? * Yes No May Be Please tell us the reason for your answer. Please tell us why you are interested in joining the E2C2 Club * * Required Create Your Own Email Form