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NSBE-WBESS Membership Application

First Name:* Last Name:*

Address Line 1:* Address Line 2:

Apt #: City: State: Phone:1* Zip:*

Email id:* @wisc.edu Major:

If you chose another college outside of engineering, please specify:

Classification: Graduation Date: Gender:

Date of Birth: Month Day Year:

Resume:2 How do I create a resume?

Please fill out the questions below

Are you interested in**

How did you hear about NSBE?

If other, please specify:

Would you like to add any exams to our database? If yes, how many?

Interested in being in a mentor program?

How many years have you been in NSBE? Have you previously held a board position?

What commitees will you be interested in joining?**

Current Semester Schedule (i.e. PHYSICS 112, MATH 103, ECE 553, etc. as listed in the timetable)

Course Name: Course Number:

Course Name: Course Number:

Course Name: Course Number:

Course Name: Course Number:

Course Name: Course Number:

What type of things would you like to see NSBE-WBESS do this school year?

* - required field
** - hold down the ctrl key to select more than one choice
1 - enter phone number in the format 1234567890 with no parentheses or dashes.
2 - make sure the resume is in MS Word document

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