Office of Multicultural Affairs
Connections Leadership Program

Connections Leadership Program Registration

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    First Name:

     

    Last Name:

     

    Email:

     

    SU Student ID:

     

    Telephone:

     

    Cell Phone:

     

    Address Line 1:

     

    Address Line 2:

     

    City:

     

    State:

     

    ZIP:

     

    Are you a Freshman or Transfer:

             

    Ethnicity:

     

    Gender:

    Will you be living on campus during the school year?

             

    Are you registered for Summer in Seattle?:

             

    Are you a Costco Scholar?:

             

    What is your t-shirt size:

     

    How many guests will you bring
    to the opening social on Wednesday?:

     

    Guest(s)' Name(s):

     

    Do you have any Dietary or Accommodation needs?:

     

    Any other comments or information you'd like to share:

     

     

     A fee of $60.00 will be added to your fall quarter tuition bill.  This fee helps to defray the cost of the program.