Official 2017 Afrikan Black Coalition Conference Application
Welcome to the Official Individual Application. Please submit
If you have any questions please contact MaRonda George at
For those attending with a group, please ensure your ABC Rep/Group leader completes the Group Delegation Registration at by November 30st.
Are you attending with a group? *
(i.e., She/Her/Hers, He/Him/His, They/Them/Theirs, Ze/Zhem/Zeirs, etc.)
Your answer
First Name *
Your answer
Preferred Name
Your answer
Last Name *
Your answer
Your answer
Phone Number *
(xxx) xxx-xxxx
Your answer
Campus *
Your answer
Class Year *
Major/Minor (or Intended) *
Your answer
Intended Career/Profession *
Your answer
Considering your identity (i.e., gender, sexuality, abilities, religion, etc.), who would you feel most comfortable rooming with? *
i.e., I am a cis woman and have no preference, my faith is important and I'd like to room with a Muslim man, etc.
Your answer
T-Shirt Size *
Dietary Restriction *
Do you need any support services? *
(i.e., Interpreter, wheel chair accessible, ability services, etc.)
Your answer
Do you foresee any economic barriers to attending the conference? *
Are you interested in hosting a workshop? *
ABC Conference Workshops Suggestions
Your answer
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