Marshall University | Center for African American Students' Programs

25th Annual Outstanding Black High School Students' Weekend Registration Form/Hotel Information

Student Information
Student's Name:	(Required)
Full Address:	(Required)
Telephone:	(Required)
Email address:	(Required)
High School :	(Required)
Field of Interest :	(Required)
WILL ATTEND :	Yes No (Required)
I desire campus housing :	Yes No (Required)
I plan to attend the Awards Breakfast on Saturday A.M., Nov 5th :	Yes No (Required)
Please plan to arrive by 11:00 a.m. on November 4th
T-Shirt Size (S, M, L, XL, 2XL, 3XL):	(Required)

If parents or guardians plan to attend, please provide the following information
Number of Parents/Guardians attending:	(Required)
Parents/Guardians will attend Friday Dinner:	Yes No (Required)
Parents/Guardians will attend Saturday Awards Breakfast:	Yes No (Required)
*PARENTS, PLEASE BE READY TO PICK UP YOUR STUDENTS BY 12:00 NOON ON SATURDAY, NOVEMBER 5, 2011!!!

Recommended Hotels Near Marshall University
Ramada Limited - 3140 16th St., Huntington, WV (2 miles) Pullman Plaza- 1001 3rd Ave., Huntington, WV (1 mile) Holiday Inn Hotel & Suites - 800 3rd Ave., Huntington, WV (1 mile) Townplace Suites - 157 Kinetic Drive, Huntington, WV (2 miles)	(304) 523-4242 (304) 525-1001 (304) 523-8880 (304) 525-4877