Women's Veterans Conference, Monday April 30th, 2012

Please fill out the form below to register for the Women's Veterans Conference.
Name: (required)
Address:
Telephone: (required)
E-mail Address: (required)
Service Branch:  ArmyAir ForceCoast GuardMarinesNavyNONE
Were you deployed?:	YesNo
If Yes, during what period?:
Are you Affiliated with a CUNY Institution? YesNo If Yes, please choose your institution from the list below:
Choose Your College Baruch Brooklyn CCNY Staten Island Hunter John Jay Lehman Medgar Evers NYC Tech Queens York CUNY Grad Center CUNY Grad School of Journalism CUNY School of Law CUNY School of Professional Studies CUNY School of Public Health at Hunter College Macaulay Honors College Borough of Manhattan CC Bronx CC Hostos CC Kingsborough CC LaGuardia CC Queensborough CC New Community College at CUNY
At this institution, please indicate whether you are(check any applicable): Veteran; Staff Member;Faculty Member; Student;
What College do you attend?
Current place of employment:
Title:
Do you require any special accommodations? If so please indicate below:
Do you have any Special Dietary Needs? If so please indicate below:

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