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Movement Mondays
Registration Form
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* Indicates required question
What is your name? (Last, First)
*
Your answer
What is your T number?
*
Your answer
What is your preferred email address?
*
(Where do your prefer to receive the weekly reminders and program information.)
Your answer
How do you identify?
Female
Male
Trans
Non-binary
Other
Prefer not to say
Clear selection
What is your status?
Student
Staff
Faculty
Clear selection
Where do you live?
On campus housing
University District
Little Rock Metropolitan area
In Arkansas, outside the metropolitan area
Outside Arkansas
Clear selection
Where do you work?
UA-LittleRock Main Campus
UA-LittleRock Bowen School of Law
Little Rock Metropolitan area
In Arkansas, outside the metropolitan area
Outside Arkansas
Clear selection
If you work at a campus, what is your building and room number?
Your answer
What is your t-shirt size? (t-shirts are limited to occasional prize drawings only)
S
M
L
XL
2XL
3XL
Clear selection
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