Name
*
First Name
Last Name
Department
*
Email
*
Butte College email address required (for BC employees)
Phone Number
-
Area Code
Phone Number
Do you plan on having lunch with us?
*
Yes
No
Do you have any dietary restrictions?
*
Yes
No
If yes, please describe
*
Employee Classification
*
Full-time Faculty
Associate Faculty
Classified
Management
Other
Flex OR $175 stipend
*
Flex
Stipend
N/A
Have you attended the Associate Faculty Conference before?
Yes
No
Submit
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