Wufoo

For People of Color Inc. Event Registration

Indicate Workshop You Would Like to Attend

All workshops are full. Please do not register.
Name * First Last
Email *

Valid e-mail is required to receive event information.
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone * - (###) - ### ####
Gender
Race *
African American Asian Chicana/o Latina/o Native American Pacific Islander Other (specify below)
Race (other)
LGBT *
Student/Professional Status *
Student/Professional Status (other)
Undergraduate Institution (use full proper name) *
Graduate Institution (use full proper name) *

If none, enter "NA"
Law School (use full proper name) *

If none, enter "NA"
Current Employer *

If none, enter "NA"
Do Not Fill This Out