Fill out and submit this form to register for the upcoming Black Student Success Summit.

We would like to know more about you! Please take the time to fill out the questionnaire, this is your ticket to lunch on the day of the event. Thank you!

If you prefer, you can download the 2019 BSSS Registration form to print and fill out later.

If you are registering a group, please fill out the 2019 BSSS Group Registration form.

Fields marked with an * are required

FOR STUDENTS

We would like to know more about you! Please take the time to fill out the questionnaire, this is your ticket to lunch on the day of the event. Thank you!


FOR ADULTS