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Student Leadership and Activities
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Yes, I will attend...

Please fill out the fields below to confirm your registration for the annual Focus on Leadership conference on the WOU campus.

 
Attendee Information
First Name:   MI:   Last Name:
   
Home Address:
City:   State:   Zip:
   
Phone:   E-mail (required):
 
Academic Major:
What is your year in school? What school do you attend?
Academic Standing: : 

T-SHIRT SIZE
Do you have any special dietary needs?
  Yes    No
If "Yes", please elaborate
Do you need any accommodation of disabilities to attend this event?
  Sign Language Interpreter     Mobility Assistance     Other (Please Specify Below)
Other Questions? (We will contact you via e-mail to answer your questions)
  This registration is submitted via e-mail. You will be asked to confirm your e-mail
after clicking this register button; you must do so to fully submit your information.

 

Contact

Student Leadership and Activities 503-838-8063 | or e-mail: tuckerj@wou.edu

MissionWestern Oregon University | 345 N. Monmouth Ave. | Monmouth OR 97361 | 503-838-8000(V/TTY) | 1-877-877-1593 | webmaster@wou.edu Text only
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