Please fill out completely to keep posted on YPC activities. First Name * Last Name * E-mail * AIChE Membership ID * Gender * - Select -FemaleMaleRather not Say Birthdate * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 Will not be used for marketing purposes. Select one of the following that applies to you: * "I am not an AIChE member or am over 35, but I still want to be informed about YPC events." "I am an AIChE member under age 35 and want to be informed about YPC events." "I am a student would like to be informed about YPC events" "I have been elected or appointed to an office." "Please remove me from the committee. I do not want to be informed about YPC events." If you have been elected or appointed as an officer, what is the name of your new office? * Do you currently participate in an AIChE local section? * - Select -YesNo If so, which one? * Which of these categories do you currently fall into? * Industry Postdoc/Faculty Graduate Student Leave this field blank