Private – ACS Inclusive Pedagogy Institute Registration Form IPI Registration Form Your Institution * Birmingham-Southern College Centre College Centenary College Davidson College Furman University Hendrix College Millsaps College Morehouse College Rhodes College Rollins College Sewanee: The University of the South Southwestern University Spelman College Trinity University University of Richmond Washington and Lee University First Name * Last Name * Preferred Name * Title * Department/Discipline * Cell Phone Number (will not be shared) * Email * Dietary Restrictions (If any) Emergency Contact Name * Emergency Contact Cell Phone Number * Transportation Information Airline Flight # Arrival Date Arrival Time 121234567891011 : 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 AMPM Do you require on-campus housing? * Yes No What do you hope to gain from this experience? * If you are human, leave this field blank. Next Δ Please note that invoices for this event will be sent after July 1st, 2022. Please go to the following URL before Wednesday, June 29, 2022, and complete a “trading card” to introduce yourself to the group: https://docs.google.com/presentation/d/1wF49NpoawlkK6QBtpA-R9hKcv0wQheab3XseMoJ5sbo/edit#slide=id.gb2d8358fa3_0_88
