Makerspace User Information and Waiver

First Name

Last Name

Date of Birth (mm/dd/yyyyy)

Your Institution

Department/Major

Phone Number

Institution Issued Email

If a student, what is your expected year of graduation?

How did you learn of the makerspace? Select all that apply.

What technology/equipment/or materials would you like to see in the makerspace?

For now, how do you plan to use the makerspace?

Are you interested in helping with classes or programs in the makerspace?

If so, what projects or topics?