The University of Rhode Island Multicultural Center
74 Lower College Road
Kingston, RI 02881
Phone: 401-874-2851
Fax: 401-874-5952
Email: mcc1@etal.uri.edu
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MULTICULTURAL STUDENT ORGANIZATION LEADERSHIP RETREAT

[ QUESTIONS MARKED WITH A * ARE REQUIRED ]
 
* 1. Name of the participant    
* 2. Campus Phone
  3. Alternate Phone
* 4. Cell Phone
* 5. Email
* 6. Address Line 1
  7. Address Line 2
* 8. YearFreshman
Sophomore
Junior
Senior
Graduate
 
* 9. GenderMale          Female
* 10. Name of your Student Organization  
* 11. How are you affilicated with that Student Organization President
Vice President
Secretary
Web Master
Public Relations
Assistant Secretary
Treasurer
Assistant Treasurer
Multicultural Representative
Academic Advisor
Past Leader
Present Leader
Future Leader
  Other:
   

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For more information about this site, contact the Multicultural Center at mcc1@etal.uri.edu

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