Presented by: Higher Education Diversity Initiative Team

WHEN: Wednesday, October 3, 2012
 1:00-4:30 p.m.
 LOCATION: Moraine Park Technical College
Cyber Center, A-109
Fond du Lac, Wisconsin

The first 75 people to check in on October 3^rd will receive a special prize.

Registration

Attendee Affiliation (select one)

Marian University Moraine Park Technical College Ripon College University of Wisconsin - Fond du Lac Community Business Group Other
                      

First Name(s):

Last Name(s):

Address:

City:

State: (Select) Alabama Alaska American Samoa Arizona Arkansas Armed Forces Americas (except Canada) Armed Forces Europe, Canada, Africa, Middle East Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Federated States Of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Zip:

Email Address:

Contact Phone:

Special Needs:

Workshop Schedule & Sign-up

12:30-1:00 Registration

1:00 - 4:00  Workshop Speaker

4:00 - 4:30 Wrap-up

Maura Cullen    

  -Register Early. Space is limited!