Save & Return

Save your progress and complete this form later. (optional)

"I HAVE A DREAM" Foundation 2nd Annual Alumni Reunion July 13-16, 2017

First Name *

Last Name *

Date of Birth *

Gender *

Ethnicity *

T-shirt size (Adult Sizes) *

Which “I Have A Dream” Foundation program were you enrolled in? *

In what year did you enroll in the "I Have A Dream" Foundation? *

Please list your career industry and highest level of schooling completed. *

Do you have a cell phone? *

Cell phone number *

Please list the best number to reach you *

Your email address *

Your Twitter Handle and Facebook ID

Do you have any allergies to food or medications, or any dietary restrictions (Kosher, Halal, vegetarian, vegan, gluten-free, etc.)? *

Please list your allergies/dietary restrictions here. *

Reunion Questions

What types of workshops, activities, or icebreakers would you like to have at the reunion? *

Would you be interested in leading a workshop session? *

What topic would the workshop cover? *

What are your academic, personal, or career goals for the future? Please list in order of importance to you. *

Gender *

Have you attended an "I Have A Dream" Alumni Reunion before? *

What year(s) and location(s)? *

0/255 characters

Payment

Payment Registration Deposit and Payment Options: Please select your preferred payment plan below. We will process your $150 deposit now to save your spot, and will follow up with you directly to process your full payment or installment plan. *

Deposit (150.00) + full payment (315.00) SINGLE ROOM (TOTAL COST $465)

Deposit + full payment (150.00) SHARED ROOM (TOTAL COST $150.00)