Líderes Congreso- Oklahoma City, OK

1. Registration Form

 
Please complete the following information. Required fields are marked with an asterisk (*). Please fill in blank lines with N/A. If you have any problems with the registration form, please email leadership@nclr.org or call Berenice Bonilla at (202) 776-1741.





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1. Name:
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2. High School, University, College or Organization:
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3. Are you a/an: (You may check more than one)

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4. Permanent Address: Please fill out all lines. Please fill in blank lines with N/A.
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5. Campus Address:Please fill out all lines. Please fill in blank lines with N/A.
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6. Contact Information:
7. How did you hear about the Congreso?
8. Are you familiar with the NCLR Annual Líderes Summit? Check here if you are interested in being a workshop presenter, summit staff member, outreach volunteer, or if you would like to know more about the event.
Please fill in blank lines with N/A.
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