RISE Student Leadership Registration

Welcome Cookies & Coffee in SC118

Green Bay Campus, SC118

First Name:
Last Name:
Email Address:
I am a student at:
What is your gender?:	Female Male Other (please specify below)

Which category includes your age?:	18-20 21-29 30-39 40-49 50-59 60 or older
What is your race?:	American Indian/Alaska Native Asian African/African American/Black Hispanic or Latino Pacific Islander White Multiracial
Which NWTC program are you in?:
What are you hoping to get out of this series?:
What does inclusive leadership mean to you?:
All sessions will be held at the Green Bay campus. Please list any accommodation needs. :
Will you be joining us for our Free Series Kick Off Dinner on Wednesday, September 25th, 2019 at 5:00 PM?:	Yes No