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From Backpack to Briefcase Registration

Please complete and submit this form to register. You will receive an email confirmation of your registration.

Session I Workshop:    

Session II Workshop:     

Session III Workshop:   

Name:    

Local Address: 

City:   

State: 

Zip: 

Phone Number: 

         

Intended Major:  

E-mail address: 

 I am interested in attending a Dinner with a Panther on