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Southern Region UBSUC Cookout
September 28, 2019
12 noon - 4:00pm
Kenneth Hahn Park
4100 S. La Cienega Blvd.
Los Angeles, CA. 90056
Please fill in this form to register your school and students.
School Name *
Your answer
Advisor's Name *
Your answer
Number of students *
Your answer
Student #1 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #2 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #3 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #4 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #5 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #6 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #7 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #8 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #9 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
Student #10 (First, Last Name; Phone #, email, social media, emergency contact info., parent's name, parent's phone) *
Your answer
Student Officer? *
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