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Conference Delegate Application (GLACURH/NACURH)
Conference Delegate Application (GLACURH/NACURH)
Please select the conference you are applying for:
*
GLACURH
NACURH
Name
Name
*
First
Last
Preferred Name
Pronouns (if willing to share)
Where do you live on campus?
*
Andrews
Ford
Lawson
Lincoln
McKinney
Pemberton
Powell-Norton
Stevenson
Taylor
Thomas
Weller
Greek Court
EIU Email
*
Cell Phone
Cell Phone
*
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-
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Class Status:
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Freshman
Sophomore
Junior
Senior
Graduate
T-Shirt Size
*
Small
Medium
Large
X-Large
XX-Large
XX-Large
Emergency Contact
Emergency Contact
*
First
Last
Emergency Contact Relationship
*
Emergency Contact Phone Number
Emergency Contact Phone Number
*
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-
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Insurance Provider
*
Policy Number
(If EIU Student Health Insurance your policy number is your E Number)
*
Insurance Provider Phone Number
Insurance Provider Phone Number
*
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-
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Where did hear about this leadership opportunity?
Where did hear about this leadership opportunity?
RHA Meeting
NRHH Meeting
Panther L.E.A.D.S.
Posters
Other
Other
Have you been to a RHA/NRHH, GLACURH, or NACURH leadership conference?
*
Have you been to a RHA/NRHH, GLACURH, or NACURH leadership conference?
Yes
No
What do you hope to gain from going to this conference?
*
What do you hope to gain from going to this conference?
Connections
Meeting New People From Other Schools
Make New Friends
Get New Experiences
Visit a Different University
Get More Involved
Bring Something Back to EIU
Get Free Stuff
Other
Other
In a sentence or two, answer how will going to this conference help you become a better student leader?
*
Maximum of
150
characters allowed.
Currently Entered:
0
characters.
What are your future plans for involvement within RHA, NRHH and/or University Housing?
*
Maximum of
150
allowed.
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0
.
Summarize why do you think you’d be a good delegate for this conference?
*
Maximum of
150
characters allowed.
Currently Entered:
0
characters.
We leave on Friday morning and return on Sunday afternoon. How do you plan to manage your schoolwork while traveling for the weekend?
*
Maximum of
150
characters allowed.
Currently Entered:
0
characters.
Please list any dietary restrictions, preferences, or needs you'd like us to be aware of.
What time does your last class end on Fridays? Put N/A if you don't have any classes.
*
Do you need any accommodations? (examples: technology)
Maximum of
150
characters allowed.
Currently Entered:
0
characters.
Is there anything else you'd like us to know?
Maximum of
150
characters allowed.
Currently Entered:
0
characters.