JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
LUC Black Graduate Alliance Email List
Please fill out the following form to join the Black Graduate Student Alliance Email Listserv
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Individual or group/school/program/office
Individual
Group/Program/School/Office
Clear selection
Group/Program/School/Office name?
Your answer
First Name
Your answer
Last Name
Your answer
Preferred Email
*
This can be your personal email, program email or LUC email. Please double check that there are no errors.
Your answer
Gender Pronouns
*
She, Her
He, him
They, Them
Other:
School
*
i.e. School of Education, School of Law. Please avoid acronyms or abbreviations.
Your answer
Program currently enrolled in
*
i.e. School Counseling, Community Health. Please avoid acronyms or abbreviations.
Your answer
Level
*
Masters (MA, MS, MEd)
PhD
EdD
JD
Faculty/Staff
Other:
Expected Graduation Date
i.e. Spring 2018, Fall 2020
Your answer
Birthdate
We will use this info to send out birthday emails and also to focus our programs to things that are age appropriate for our members. You do not need to answer this question if you feel uncomfortable.
MM
/
DD
/
YYYY
What kinds of programs are you interested in seeing a BGSA sponsor?
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
