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Clarke IPCW Registration

First Name  
Last Name  
Address  
City  
State  
Zip  
E-mail  
Phone  
High School  
Graduation Year  

Transferring Institution

  (if applicable)
Academic Interest(s)
Click here for a list of options.
 
Athletic Interest(s)
If you would like to meet with a coach, please select from the list provided.
 
 
 

 
 
 If other, please list:  
 
 Event Information
 
 
 IPCW Session  M  A
 
 T-shirt Size
 
 
 IPCW Lunch (optional)  I plan on having lunch after the morning  
     session.
 I plan on arriving early and attending
     lunch before the afternoon session.
 Number of Visitors 
  
 (including yourself)
Are any of your visitors Clarke Alumni?
If yes, list the name and relation of alum below.
Name:  

Relationship to the Attendee:

 
   
  • STEM Day 2014
  • TimeSaver Program
  • Arts @ Clarke