United States Student Association National Student Power Summit Delegation Registration Form, 2018
We are happy to invite you to the 2018 National Student Power Summit: Empower the Masses, Reclaim Our Space, taking place April 6th- April 9th, 2018 in Washington, DC.

This year everything students and our communities fought for in the past decades has been threatened; increased attacks, both verbal and physical, have made students and their communities feel unwanted and unsafe in this country. It is more important than ever to ensure that we use our positions of privilege in higher education to fight for education justice. As students we have the power to create change, not only on our local campuses, but at a national level as well. Join us and students all around the country, as we work to 'empower the masses and reclaim our spaces.'

Please submit this form to reserve your spot at the National Student Power Summit 2018. Please fill out all questions. The final deadline to submit a delegation to the convention is March 27th, 2018!
Take advantage of reduced conference registration rates by submitting a delegation before the Regular Registration deadline, March 13th, 2018!

NSPS 2018: Empower the Masses, Reclaim Our Space will be held at the National Education Association (NEA,)1201 16th St NW, Washington, DC 20036.

Email address *
Delegation Information
In what region is your campus located? *
In what state or territory is your campus located? *
Your answer
Delegation: Which campus, statewide student association, or organization is your delegation representing *
Please type the full name of your campus, statewide student association, or organization.
Your answer
How many delegates will be in your delegation? *
How many students will be part of your group? NOTE: USSA is committed to recruiting a diverse group of students to work on a broad range of topics and build student power. We encourage you to reach out to student organizations including women; black and brown students; lesbian, gay, bisexual, or transgender students; veterans; students with disabilities; and nontraditional students and invite them to join us at National Student Power Summit and in this work.
Your answer
Delegation Leader: First Name *
The delegation leader coordinates logistics and recruitment. They are responsible for recruiting a delegation that represents the student body and meets the diversity guidelines of USSA. They must also make sure that each delegate completes the individual registration form, make room reservations, reserve parking permits if applicable, and make travel arrangements. The delegation leader is the point of contact before, during, and after the National Student Power Summit.
Your answer
Delegation Leader: Last Name *
Your answer
Delegation Leader: Phone Number *
Your answer
Delegation Leader: Email *
Your answer
Delegation Billing Information
IMPORTANT NOTE: Once registration is submitted, delegations are financially responsible for the number of delegates they list above, even if they are NOT able to attend the National Student Power Summit. It's better to register a smaller group, and than register more students if you have the financial capacity to do so. Please provide information for your delegation's billing contact below.
Billing Contact Information: First Name *
Your answer
Billing Contact Information: Last Name *
Your answer
Billing Contact Information: Email *
Your answer
Billing Contact Information: Phone Number *
Your answer
Registration Fees and Deadlines
Please submit your payment by the deadline to complete the registration process. Failure to pay for registration ON TIME may result in a higher registration fee. If we have not received your payment by March 23rd, 2018 you will not be able to attend the National Student Power Summit.

Fees:
Early Registration: USSA Members $170, Statewide Student Association $195, Non-member $220
Regular Registration: USSA Members $180, Statewide Student Association $205, Non-member $230
Late Registration: USSA Members $190, Statewide Student Association $215, Non-member $240

Early Registration Ends: February 18th, 2018
Regular Registration Ends: March 13th, 2018
Late / All Registration Closes: March 27th, 2018


***NOTE: Registration is per each student in your delegation

Registration Fee Rate: *
By submitting this form, I agree to pay the full amount corresponding to the number of delegates specified above. *
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