IEEE Entrepreneurship Tunisia Workshop

Application

Application | IEEE Entrepreneurship Tunisia Workshop

First Name*
Last Name*
I identify my gender as*
- Woman
- Man
- Genderqueer / Non-Binary
- Agender
- My gender is not listed
- Prefer not to disclose
What is your age?*
- < 20 years
- 20 - 29 years
- 30 - 39 years
- 40 - 49 years
- 50 - 59 years
- 60+ years
- Prefer not to disclose
Mailing Address: Street Address*
Address Line 2*
City*
State / Province / Region*
ZIP / Postal Code*
Country*
Phone Number*
Email Address*
Name of your current Institution*
Website of your Institution*
Your highest degree attained*
Year of graduation*
Field of Study*
University where you obtained your degree*
Are you currently a student / employed?*
If employed, your profession?*
Your technical specialization Egs. : simulation, experiments, instrumentation, programming, research, etc.*
Please tell us in a few sentences why you would like to attend this workshop and if you have any prior experience in entrepreneurship.*
About you - Tell us anything you would like us to know!*
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