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Get Power In Diversity Conference Registration Form - St. Cloud State ... - Stcloudstate

Ip Code Birth Date (MM/DD/YYYY) The information on this form is private data, used to identify and locate you and obtain payment. Name, address, and payment method are mandatory. Early Registration Rates (10/01/10 - 01/21/11) Late Registration Rates (applies 01/21/11) $75 for MnSCU students $100 for MnSCU students $95 for non MnSCU students $120 for non MnSCU students $135 for Advisors (faculty and staff) $150 for Advisors (faculty and staff) T-Shirt Size Small Medium Large X-Large XX-.

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