2nd Annual Virtual Rock Da Mic 2021

Registration Form

Please fill out this form completely!
Name *

First Name Last Name
Email *
example@example.com
Age
Gender
Language
Ethnicity
City of Residence (Alameda, Berkeley, San Francisco...etc)
I am registering to... *

Attend the event ONLY Sign Up for a Slot to 'Rock Da Mic'
If you are signing up to 'Rock Da Mic'-what will you be performing? (Each slot will be allocated roughly 5 mins) *
There will also be a Costume Contest with a prizes. Will you be entering the contest?

Yes No
Thank you for your submission! Every submission will receive an email with the zoom login information prior to the actual date of the event. If you have signed up to 'Rock Da Mic', you will be contacted shortly by a PIWI staff member to provide you with the theme and criteria of the event. Please ensure your contact information is accurate and up to date.
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Registration Form