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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.

    
 
 
 

Contact us

Contact WIE Staff at: women@ieee.org