WIE has promotional items available for Affinity Group events and activities. To request the items, please complete and submit this form.
Items should be requested at least three-weeks prior to the event.
If you have any questions about the items, please contact WIE at women@ieee.org.

Request Form

* required field

Contact Information
Requester's Name and Title:
WIE Affinity Group Name:*
Requester's Address (including city, country, and postal code if applicable):
Requester's Phone Number:
Requester's E-mail:*

Event Information
Event Name and Date:
Event Location:
Event Audience:	(Pre-university or university students, profesionals, etc)
Estimated Attendance:

Promotional Items Information
Name of person items will be mailed to:	(If same as above put "N/A")
Date to receive items:
Address to send items (including city, country, and postal code if applicable):
Phone number of person receiving shipment:	(if same as above put "N/A")
E-mail of person receiving shipment:	(if same as above put "N/A")
Comments:	*Items should be requested at least three-weeks prior to the event.