Request edit access
BLOC University Akron - Class 1 Registration
Sign in to Google to save your progress. Learn more
Name *
Email: *
Phone Number: *
Are you part of an organization? If so, which one? If not, please put NA.  *
Do you need any dietary accommodations? Please list.  *
Do you need any accessibility accommodations? Please list.  *
How many children will be attending with you?  *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Black Leadership Organizing Collaborative.

Does this form look suspicious? Report