CED Inclusion Project - Friday, February 28, 2014 Registration Form: Voices Carry: Embody the Change Question Title * 1. First Name: Question Title * 2. Last Name: Question Title * 3. Affiliation Faculty Staff Student Not listed (please specify) Question Title * 4. Position Title (for faculty/staff) Question Title * 5. Class Standing (for students): Freshman Sophomore Junior Senior Graduate Not listed (please specify) Question Title * 6. Email Address: Question Title * 7. Preferred Phone: Question Title * 8. Dietary Needs (optional): Vegetarian Vegan Gluten Free Not listed (please specify) Question Title * 9. Reasonable accommodation needs (optional): Question Title * 10. Gender Pronoun Preference: Masculine (he/him/his) Feminine (she/her/hers) Gender Inclusive (please specify) Question Title * 11. Will you attending breakfast from 8:00 - 8:50 am? Yes No Comments (please specify) Question Title * 12. Will you be attending lunch from 12 Noon - 12:50 pm? Yes No Comments (please specify) Thank you. We look forward to seeing you on Friday, February 28, 2014 in the Memorial Union for Voices Carry: Embody the Change. Done