Contact Information |
| First Name: | |
| Last Name: | |
| E-mail: | |
| Address Line 1: | |
| Address Line 2: | |
| City: | |
| State: | |
| Zip/Postal Code: | |
| Country: | |
| Preferred Phone: | |
| Business Phone: | |
| Cell Phone: | |
| U.Va. School of Graduation: | |
| U.Va. Year of Graduation: | |
| Club, Organization, or Interest Group You Represent: | |
| Title at Club, Organization, or Interest Group Your Represent: | |
| Nametag Name: | |
Personal Bio:
(To be included in Conference materials.) | Please describe yourself below in 250 words or less. You might
include personal history and interests, fond U.Va. memories
or volunteer experience.
|
Conference Events
(Please Check All Appropriate Boxes) |
Friday | Reception
|
| Saturday | Conference (Business Casual)
Saturday Dinner (Dressy Casual)
|
| Dinner Selection | Vegetarian
Non-Vegetarian
|
| Saturday Dinner Guest | |
| Guest's Dinner Selection | Vegetarian
Non-Vegetarian
|
| Saturday Morning Breakout Session | |
| Saturday Afternoon Breakout Session | |
Sunday | Strategic Planning Session/Breakfast
|
Comments |
| Special Needs, Requests or Comments: | |
