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23rd Annual Outstanding Black High School Students' Weekend Registration Form/Hotel Information

Student Information

Student's Name:

  (Required)

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 7th :

Yes   No (Required)

Estimated time of arrival Nov. 6th :
(Please plan to arrive by 11:00 p.m.)

  (Required)

T-Shirt Size (S, M, L, XL, 2XL, 3XL): 

  (Required)
 
If parents or guardians plan to attend, please provide the following information
Name(s) of Parents/Guardians attending: (Required)
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 7, 2009!!!
  
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)
(304) 523-4242
(304) 525-1001
(304) 523-8880



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