Mack Gives Back 2017 - Employee, Graduate Student, & FYE Mentor Registration
This form is for faculty, staff, graduate students, and accompanying friends of faculty/staff who would like to participate in Mack Gives Back Day on Saturday November 4th, 2017.
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Email *
First Name *
Please provide your first name (as it will appear on your name tag).
Last Name *
Please provide your last name (as it will appear on your name tag).
Role on Campus *
Please select your role on campus.
Department Name
Please indicate which department you work for (if applicable).
Please select your role on MGB: *
Required
Accompanying Persons
If you are bringing people from outside of Merrimack College with you please indicate their name(s) here.
Accompanying Minors
If you or someone you are bringing is UNDER THE AGE OF 18 please indicate that age here.
Allergies
Please indicate any allergies you may have (peanut butter, latex, etc.).
Special Accommodations
Please indicate if you require any special accommodations regarding transportation, service assignment, etc.
Email Address *
Please provide your email address.
Questions, Comments, or Concerns
Please let us know if you have any questions, comments, concerns, or if you need to tell us any information. If you are going to be a Trip Adviser please let us know if you want to advise a specific group here.
A copy of your responses will be emailed to the address you provided.
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