Affiliates Leadership Conference (Winter) Pre-Registration

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This is the Pre-Registration for the Affiliate Organization

First Name *

Last Name *

Email *

Contact Number (#) *

Affiliate Organizations (Choose 1 Affiliate Org you will be representing) *

Students For Justice in Palestine (SJP)

Black Student Union (BSU)

MEChA (Movimiento Estudiantil de Chicano/as de Aztlan)

Kaibigang Pilipino (KP)

PUSH (Pilipino Undergraduate for Health)

MSA (Muslim Student Alliance

CYUAG (Christain Youth United for the Advancement of the Gospel

CARAS (Central American Raising Awareness & Solidarity)

APSA (Asian Pacific-Islander Student Association)

NASA (Native American Student Alliance)

Kamalyan Collective

ASA (African Student Association)

CSC (Catholic Student Community)

Student Worker Collective

SDC (Student With Disabilities Coalition)

UJS (Union of Jewish Students)

CSAP (Coalition of South Asian Peoples)

QPOC (Queer People of Color)

Will you be attending Dinner at 5PM? *

Yes

Required

Do you have ANY Dietary Needs (i.e. Vegetarian, Vegan, Pescatarian) *

Yes (If yes specify in the Other Box)

Other:

Required

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