XITO Summer Institute 2021 Registration
Email address *
First Name *
Last Name *
Email *
Phone # *
Organization Name (school, community group...) *
Have you attended any XITO institutes in the past? *
Name of PayPal payee if different from participant's name (school admin assistant or other)
Please indicate below your agreement to allow your name and likeness to be reproduced in XITO promotional materials including social media and websites affiliated with the Xicanx Institute for Teaching and Organizing. *
A copy of your responses will be emailed to the address you provided.
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