Student Debt Clinic Registration
Please fill out the below information to register for one of two student debt clinic sessions hosted by United Academics of Philadelphia (UAP) on Friday, March 18, 2016. These 90-minute sessions are offered to UAP members and will be held at the UAP office, located at 1215 N 29th St, Philadelphia, PA 19121.

After you register, you will receive a survey about your experience with student debt. Your responses will remain confidential, but any information you provide will help our facilitators design a session that is most effective for everyone attending.

Which session are you registering for? *
Both sessions will be held at the UAP office, located at 1215 N 29th St (near Girard) in Philadelphia. Space is limited, so please select the specific time you plan to attend.
Name *
Your answer
I teach at/attend the following school(s): *
Your answer
Non-institution e-mail: *
Your answer
Best phone to reach you: *
Your answer
Are you currently a member of United Academics of Philadelphia? *
Are you currently a member of another local chapter of the American Federation of Teachers? (ex: TAUP, FSFCCP, etc.) *
If you answered yes to the above question, which local chapter of the American Federation of Teachers do you belong to?
Your answer
I'm interested in attending the Student Debt Clinic because: *
(choose all that apply)
Required
What type of student loan debt do you have? *
(choose all that apply)
Required
Are you up-to-date in making your monthly student loan payments? *
Are you currently in default on your student loans? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms