PACAC College Access Forum - 2012 Registration

Important questions to help us plan this event:

Question Title

* 1. Tell us about yourself:

LAST NAME:

FIRST NAME:

TITLE

INSTITUTION/ORGANIZATION:

ADDRESS 1:

ADDRESS 2:

CITY:

STATE:

ZIP:

PHONE:

CELL PHONE:

EMAIL:

Question Title

* 2. Will you be participating in the College Access Forum (Monday)?

Yes

No

Question Title

* 3. Will you be partipating in the "Walk on the Hill" (Tuesday)?

Yes

No

Question Title

* 4. Will you be reserving a room at the Harrisburg Hilton for Sunday, May 20th?

Yes.

No.

Question Title

* 5. Will you be reserving a room at the Harrisburg Hilton for Monday, May 21st?

Yes.

No.

Question Title

* 6. Have you previously attended a PACAC/NACAC or other conference focused on College Access?

Yes.

No.