Mylan HackSummit 2015 Registration

1. Your Name: *This question is required.

Please be sure that you and your teammates all enter the same name so that we can match you up appropriately.

2. Team Name: *This question is required.

3. School or Group Affiliation:

4. Major:

In the event that we need to communicate changes to the event, etc.

5. Email Address: *This question is required.

6. Phone Number In the event that we need to communicate changes to the event, etc.

7. Twitter Handle

8. Please list any food allergies or other special considerations we should be aware of:

10. Which challenge are you taking?

Please complete this form in its entirety.