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Leadership Symposium
Which Leadership Symposium will you be attending?
*
Native American Leadership Symposium - October 2
Asian American Leadership Symposium - October 11
LatinX Leadership Symposium - October 23
Black Leadership Symposium - November 1
If attending multiple symposiums please fill out a separate registration form for each one.
Name of High School or Program/Organization name
*
Billing Address of High School or Program/Organization
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What school district is your High School is?
Group Sponsor's Full Name
First Name
Last Name
Sponsor's email address
*
Cost is $15/person. Payment Options:
*
I'll bring a check on event day.
Bill me after the event.
$15 per student. Counselors will only be charged $15 to attend, even if a counselor chooses to attend more than one symposium.
How many students will be attending?
*
How many sponsors/staff members will be attending?
*
Day-of Transportation - Do you plan to arrive in a van/car or a bus?
van or car (will need parking garage validation)
bus
How did you hear about Leadership Symposiums?
poster
email
social media
colleague
Other
Does anyone in your group require assistance with mobility, a sign language interpreter, or dietary restrictions?
Yes
No
If Yes, please provide details of your request for accommodations:
List of students who will attend (*this is not necessary to complete registration, but is appreciated now if you know the students attending):
Ex) John Smith - 12th grade
Submit
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