Student Day Registration

Instructor First Name *

Instructor Last Name *

Instructor Phone#

Instructor Email *

School Name *

School Address *

City *

State *

Zip Code *

What component manufacturer invited you and your students to the BCMC Show?

If none, would you like to be connected with a local manufacturer?

Yes, please connect me with a local manufacturer.

Please list student first and last names (up to five) that will be attending the BCMC Show.

If parents are attending with your students, please list their names here.

Leave this field blank