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Mission & Service Day Registration 2018
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* Indicates required question
Email
*
Your email
Organization Name
*
Your answer
Please list mission/service opportunities available for EMU students and graduates (or include a link for information)
Your answer
Primary Contact
*
Your answer
Primary Contact Email Address
*
Your answer
Primary Contact Phone
*
Your answer
Organization Website
*
Your answer
Names of Representatives Attending
Your answer
Total Number of Representatives Attending
*
Your answer
Number of Lunch Passes Needed
*
Your answer
Need Electrical Outlet? **If yes, please bring extension cord**
*
Yes
No
A table and two folding chairs will be provided- any additional needs?
Your answer
Any additional comments?
Your answer
A copy of your responses will be emailed to the address you provided.
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