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Username *

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E-mail address *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

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Please re-type your e-mail address to confirm it is accurate.

1. Personal

First Name *

First name

Last name *

Last name

Daytime phone *

Daytime telephone number

Company / Organization name *

Name of company or organization

Name and Address

First Name *

Last Name *

First and last name will be shared with other visitors to the site.

Street Address (Home)

City (Home)

Postal Code (Home)

Country (Home)

Your state/province and country of residence will be shared with others so folks can find others in their community.

State (Home)

EWB-mailing-list-signup

2. Professional

Professional field

Professional (work) field

Other / Specialty area

Profession years

How many years have you worked in that field / profession?

License

Do you have a professional (engineering) license?

License (other)

If other license, please specify.

Project type

What type of projects do you generally work on?

Project roles

What role(s) have you performed in this work?

Engineering interests

Do you have any other engineering interests or work experiences that would be relevant to EWB? (i.e. work in other fields, hobbies, etc)

Nonprofit experience

As part of your professional work experience, have you worked for or with non-profit organizations on engineering type or related projects in developing countries? What type? Where? When? In what role? What scale?

3. Personal Experience

Developing-country experience

Do you have any experience (working, extended travel or living) in a developing country? For example, with the Peace Corps, church projects, travel, family connections etc. When? Where? How long?

Language (1)

What language(s) do you speak in addition to English?

Language Level (1)

What is the level of your language ability?

Language (2)

What language(s) do you speak in addition to English?

Language Level (2)

What is the level of your language ability?

Language (3)

What language(s) do you speak in addition to English?

Language Level (3)

What is the level of your language ability?

Language - Other

What other language do you speak?

Language Level - Other

What is the level of your language ability?

Non-engineering skills

Do you have any non-engineering skills that might be useful? (writing, dancing, musical instrument, flying, first aid, etc.)

Fundraising experience

Do you have any fundraising experience? Describe your experience.

Help fundraising

Are you willing to help with fundraising, and how?

Leadership experience

What leadership and/or team experience do you have?

Other experience

What else should we know about you?

4. Project Interests

Time available for projects

How much time do you expect to be able to commit to a project keeping in mind that projects may run for one to two years?

Project lead?

Are you willing to be a project lead?

Project travel?

Are you willing and able to travel as part of your participation on projects, and if so for what length of time?

Regions of interest

In which areas/regions of the world are you most interested in working?

Countries of interest

Do you have specific countries in which you are most interested in working?

5. Student chapter support

Advisor to student chapter?

Are you interested in being a project advisor or mentor to a student chapter? If yes, check one or more roles below, or enter "Other" role.

Project leader for student chapter

Technical advisor to student chapter

Other role for student chapter

6. Want to be part of a planning committee? -- check interests

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