Student Leadership Institute Registration

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You are registering to attend the third annual Student Leadership Institute on Friday, October 18, 2019. Please check out our website for more information on the event. If you have any questions about the event or this form, please email leadership@calpoly.edu.

This is a come as you can conference - we understand you may have class or other obligations and that is ok. Come to the times that work for you!

SLI and SDLI are on the same day - all of the student focused CPX/SDLI sessions are a part of SLI 2019! We are excited for this collaboration and want to create an easy transition for you between events.

Please answer the following questions to complete your application. Currently there is no deadline for this portion of the Student Leadership Institute- students may submit their application at any time.

Email *

First Name: *

Last Name: *

Cal Poly Email: *

I am a.... *

1st year student

2nd year student

3rd year student

4th year student

5th year student

6th + year student

1st year transfer student

Graduate student

Staff

Faculty

Other:

Major/Graduate Program: *

Please share your gender pronouns:

Pronouns are the grammatical terms used to refer to someone in the third person, which we cannot know just by name or appearance. You may mark all that apply.

She/Her/Hers

They/Them/Theirs

He/Him/His

Ze/Zir/Zirs

Other:

I will be present for the following meals: *

Breakfast (10 - 11am)

Lunch (12:10 - 1pm)

Both

Please list any dietary needs or restrictions you have.

Please list your current extra-curricular involvement at Cal Poly: *

Questions, comments or notes?

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