Individual Registration Use this form to complete your Student Symposium Individual Registration. Individual RegistrationEach team must register and list the names of all team members. Every student must also complete an individual registration. Payments may be completed by credit card during registration or a check made out to “ASCE Texas Section” may be mailed to: ATTN: Student Symposium 2020 ASCE Texas Section 1524 S IH 35 Ste 180 Austin, TX 78704 The individual registration deadline is January 22, 2020. Late registration will be from January 23 - February 12.Name:* First Last Email:* Phone:University*Angelo State UniversityLamar UniversityTarleton State UniversityTecnologico de MonterreyTexas A&M UniversityTexas A&M University-KingsvilleTexas Tech UniversityThe University of Texas at ArlingtonThe University of Texas at AustinThe University of Texas at El PasoThe University of Texas at San AntonioThe University of Texas at TylerThe University of Texas Rio Grande ValleyUniversidad Autonoma del Estado de MexicoUniversidad La Salle VictoriaUniversidad Nacional Autonoma de MexicoUniversity of HoustonWest Texas A&M UniversityOther (please specify below)If Other, Please List Name of UniversityT-Shirt Size*XSSMLXL2X3X4X5XDietary Restrictions:* None Vegetarian Vegan Gluten-free Other (please specify) Other Dietary Restrictions (please specify):Allergies:* None Peanuts Tree nuts Seafood/Shellfish Other (please specify) Other Allergies (please specify):Special Accommodations:* None Wheelchair User Blind or Visually Impaired Deaf or Hearing Impaired Other (please specify) Other Special Accommodations (please specify):Cost: Price: $100.00 Total: $0.00 Payment:*Credit cardMailCredit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Expiration Date Security Code Cardholder Name PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.
