IMMOC 2021 BIPOC Student Leadership Conference Registration Form

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Please fill out the information below to register yourself or your students for the conference. Updates for the conference will be on our IMMOC Facebook page.https://linktr.ee/immocmn
This conference is for:
* High school & College Black, Indigenous, students of color, and their educators
* All BIPOC gender identities welcomed

Name *

Email *

Phone number *

I am a... *

High school counselor/ advocate

High School Student

College staff/falculty

College student

Required

HIGH SCHOOL STUDENTS... Which class are you in?

Freshman

Sophomore

Junior

Senior

Clear selection

Name of high school or college/university *

T-shirt size *

XXL

Will you need any accommodations?

Yes

Clear selection

Any additional questions?

Clear form

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