Social Justice Leadership Conference Registration

Registration is due by Thursday, February 21, 2013 by 1pm.
The conference will run from 11am until 4pm on February 23, 2013 (Check-in will begin at 10:30am).
All registrants must participate in the full duration of the conference.

First Name:
Last Name:
Wes ID:
Affiliation:
Email:
Phone:
Please list any food allergies:
Conference Sessions
I will be attending the Keynote and Brunch.:	YesNo
Session Block 1: 12:10-1:00pm:
Session Block 2: 1:10-2:00pm:
Session Block 3: 2:10-3:00pm:
PLEASE READ BEFORE SUBMISSION By registering for the conference, I am inidcating that I will attend and fully participate in the duration of the conference (11am-4pm). STUDENTS: If you register that you will be attending the keynote and brunch, and fail to attend your student account will be billed $5 to assist in the cost of brunch. By pressing the SUBMIT button, I acknowledge and understand the statement above.

PLEASE READ BEFORE SUBMISSION