Suffolk University - Multicultural Summit Participant Application

Name:	*
Address:	*
Phone:	*
Email:	*
Classification:	Freshman
	Sophomore
	Junior
	Senior
	Grad Student
	Law Student
	Staff
	Faculty
Major or Department:	*
What, if any, accomodations will you require to fully participate in the summit (ASL interpreter, assistive/adaptive technology, etc.)?
Dietary preferences (vegan, vegetarian, etc.):
T-shirt Size
Racial/Ethnic Identity:
Gender Identity:
Sexual Identity:
Socioeconimic Status (SES):
Nationality:
Ability/Disability:
Religion/Spirituality:
Any other socio-cultural identity group memberships you feel are relevant: