STEM Day at PSU

First Name

Preferred First Name (if different than First Name)

Last Name

Title

Pronouns

Pronouns are the words we use to talk about a person when we’re not using their name. These might be they/them, he/him, she/her, or other pronouns. Learn more about why we collect pronouns and how they will be shared.

PSU ID

Birthdate

Are you an international student?

Yes

No

Country of Citizenship

Language Spoken at Home

Total number of guests (not including yourself)

Did any of the guests you're bringing graduate from Portland State University?

Contact Information

Email Address

Phone Number

Is this a mobile phone number?

Yes

No

Would you like to receive SMS (text) messages about event reminders, important news and deadlines?
By selecting yes, you consent to receive marketing/promotional/notification messages from PSU. To opt-out reply STOP at any moment. Msg & Data rates may apply.

Yes

No

Mailing Address

Country

Street

City

Region

Postal Code

Would you like to share the confirmation of this event registration with anyone?
If so, please provide an email.