Intercultural Students’ Weekend Registration Form

Registration deadline is Tuesday, October 15 th, 2019

Intercultural Students' Weekend Registration Form

Student's Last Name *
Student's First Name *
For proper introduction purposes, please spell your name as it is pronounced:
Student's Birthday *
Student's Permanent Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Student's Mailing Address (if different than permanent address)
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone Number
Parent or Guardian Email Address *
Student Email Address *
High School *
Junior or Senior *
What is your interested major? If unsure, enter "Undecided" *
I will attend Intercultural Students' Weekend on Friday and Saturday November 1st & 2nd. *
I will stay overnight in the MU Rec Center, Friday, November 1st. *
I will attend the Intercultural Student Breakfast, Saturday, November 2nd. **Saturday morning breakfast is for students only.*
I will attend the Intercultural Student Weekend Awards Ceremony, Saturday, November 2nd. **Family and friends are encouraged to attend the Intercultural Student Awards Ceremony.*
Please list the number of parents, guardians, and/or family members attending *
Suggested Accommodations for Family Members
- Ramada Limited – 3140 16th St., Htgn., WV 304- 523-4242;
- Holiday Inn Hotel & Suites 800 3rd Ave., Htgn., WV 304-523-8880;
- Super 8 Motel-3090 16th St. Road, Htgn.,WV 304-525-1410;
- Townplace Suites-157 Kinetic Drive, Htgn.,WV 304-525-4877;
- Hampton Inn – Hilton-177 Kinetic Dr, Huntington, WV 304-523-8001
Student's T-Shirt Size *
Intercultural student ethnicity/race information *
Select all that applyAmerican IndianAlaskan NativeAsianHispanic pr LatinoNative HawaiianOther Pacific IslanderBlack or African-AmericanWhiteOther/Not Listed
If selected "other" above, please specify below:
Please identify any particular health, medical, or dietary needs that you wish for us to be aware of? If any please briefly explain:
Have you ever attended Marshall University's Intercultural Students' Weekend in the past? *Student's are permitted to attend Intercultural Students' Weekend one time during their junior OR senior year of high school.

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Intercultural Students' Weekend Registration Form

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