Crosstown Registration

SCHOOLS MUST RESERVE SPACE THROUGH Michigan Roundtable for Diversity & Inclusion BEFORE REGISTERING: Please call Craig Anderson at 313.567.6225

* $200 program fee per school team
* $55 per student room and board fee
* $65 per advisor

Schools are invited to send a team of 6 - 8 students and 1 - 2 advisors.

Contact Information

First Name	Last Name
School
Address
City	State Zip Code
Phone
E-mail
Number of Students Number of Advisors

Date

Please Invoice Me

Please select one:

November 2-4, 2005
November 9-11, 2005

Names of Students Attending:

Student 1:

First Name

Last Name

Student 2:

First Name

Last Name

Student 3:

First Name

Last Name

Student 4:

First Name

Last Name

Student 5:

First Name

Last Name

Student 6:

First Name

Last Name

Student 7:

First Name

Last Name

Student 8:

First Name

Last Name

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