Interest & Sign-Up: Fall 2021/22
Hey there, thanks for your interest in the Brock Learners Association! Please complete the form below and we'll be in contact with you for future updates and events!

Any questions? Send us an email at brocklearners@gmail.com

*** Please use your student email, e.g. ab21cd@brocku.ca ***
Sign in to Google to save your progress. Learn more
Email *
Name *
First and last name if applicable, e.g. Marcus Villena
Discord username (e.g. marcus#2068)
We have a Discord server for events, notifications, and chat! Want to learn more? Visit brocklearners.com/discord
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy