Event Registration

2020 Presenter Registration-Middle Level Student Leadership Conference

This is a wonderful opportunity for you to share your leadership experiences and ideas with talented middle-level student leaders. Your work with the early adolescent student participants at this event has the potential to impact how they work with others and develop as thinking leaders. The goal of this event is to enhance and improve student leadership skills in the areas of school climate, acceptance, making a difference, taking risks, social media safety and awareness, communication, and mindfulness.
  • Date: January 3 and January 17, 2020
  • Time: 9:00 a.m. to 2:30 p.m.
  • Site: January 3 at Sacred Heart University, Fairfield; January 17 at Trinity College, Hartford
  • Registration Deadline: December 6, 2019
  • Cost: No Charge


Note: Items with * are required.
Registrant Name*: First*:
Last*:
Affiliation*:
Phone*:
Fax:
E-Mail*:
Re-Enter E-Mail*:
Mailing Address*:
City, State and Zip*:
Date and Location for Presenter*
Topic of Presentation*
Title of Presentation*
Will you be bringing students to present with you*
Cell Phone Number (In the event we need to reach you on the day of the event)*