RWConnection Registration

		Student Contact Information

		First Name:
		Last Name:
		Address:
		City:
		State:
		Postal Code:
		Phone:
		Email:



		Educational Interest

		Major of Interest:



		Roommate Preference
		Student RWConnection Roommate Preference (if any)




		Event Information

		Total number of people attending?*
		*There is a $15 charge for attendees other than parents and students.
		Number of parents attending?



		Parent Lodging

		Lodging is available on a "first come, first served" basis. Cost is $32 per person.
		Parent Lodging	Yes No
		Parent Information (fill out for each parent)
		First Name:
		Last Name:
		Gender:	Male Female
		Address:
		City:
		State:
		Postal Code:
		Phone:
		Email:
		Second Parent
		First Name:
		Last Name:
		Gender:	Male Female
		Contact information is the same for both parents
		Address:
		City:
		State:
		Postal Code:
		Phone:
		Email: