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What's Next? IGR Retreat
Application Form

Please fill out the following information and return it to Dr. Brighid Dwyer in the Center for Multicultural Affairs by August 31, 2012. Space is limited for the Retreat. Participants will be notified via e-mail about whether or not you have been accepted to the retreat.

First Name:

Last Name:

Cell Phone Number:

Email:
(email is required)

Class Year: (Must be a Freshman or Transfer)

Freshmen
Transfer

School:

Major:

Gender:

How do you identify
racially or ethnically?

Are you a part of any CMA programs?

Why are you interested in What's Next Retreat?

Have you had any previous experience with social justice projects, classes, or dialogues about difference? If so, please explain.

What do you hope to gain from attending the What's Next?IGR Retreat?

(Form may submit slowly, click SUBMIT only once)

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