XITO Summer Institute 2021 Registration
* Required
Email address
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone #
*
Your answer
Organization Name (school, community group...)
*
Your answer
Have you attended any XITO institutes in the past?
*
Yes
No
Name of PayPal payee if different from participant's name (school admin assistant or other)
Your answer
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.
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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