Registration for Student Environmental Retreat
We are happy that you have decided to attend the 2012 Student Environmental Retreat hosted by Bucknell University!  Please fill out the application form completely so that we will have the information we need to make this an enjoyable and rewarding experience for everyone.  The deadline to submit this application is Fri., Jan. 20.  The cost per person is $20, which will be collected at check-in on Sat., Feb. 11.  The event will be held at Bucknell University's Forrest D. Brown Conference Center, located off campus in the nearby village of Cowan.  If you have any questions or concerns, please contact us at environmental.center@bucknell.edu or call 570-577-1490.
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What is your full name? *
What is your mailing address? *
Please include house or box number, street name, city, state and ZIP code
What is your email address? *
What is your phone number? *
Please tell us the land-line or cell number that you would usually use.
Are you *
Accommodations at the Conference Center are available only for students.  Alternative housing for faculty and staff can be arranged by Bucknell. More information will be available in January.
Required
What is the name of your college or university? *
Are you a member of any environmental/conservation group? *
We are interested in learning about participants' affiliations with environmental/conservation groups on any level.
Required
If you answered yes to the previous question, please tell us the name(s) of your groups.
Are you involved in any environmental or sustainability project(s) at your school?
If you answered yes to the previous question, briefly tell us about the project(s).
What topic(s) will you be presenting at the retreat? *
Ideally, we would like to hear about at least two environmental or sustainability projects that have been implemented or are proposed for each school.
We will provide lunch and dinner on Sat., Feb. 11, and breakfast and lunch on Sun., Feb 12.  Do you have any dietary preferences? *
Required
Please list any ADA special needs.
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