WUAA Town Hall Interest Form
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you opt in to receive text messages about WUAA? By selecting Yes, you agree to get SMS/MSM updates from WUAA. Message & data rates may apply.
*
Yes
No
Cellular Number
*
-
Area Code
Phone Number
E-mail
*
Graduation Year
*
ex; 2005
Local Chapter Affiliation (if no chapter exists locally cite N/A)
*
Ex: Dayton
Category
Please Select
Housing
Financial
Student Activities
Enrollment Management
Other
Write your question below:
Category
Please Select
Academics
Housing
Financial
Student Activities
Enrollment Management
Other
Write your question below:
Submit
Should be Empty: