Sagan National Colloquium Pre-Registration Form

Registration allows us to plan for materials and spaces. Please fill out this form completely so we can communicate with you in the event of any updates.

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Note: All fields are required unless otherwise noted.

Sagan National Colloquium Event(s)

Select the Sagan National Colloquium Event(s) you wish to attend:
	September 8, 2018 – Social Justice Sewing Academy Workshop
	September 11, 2018 – Laurie Jo Reynolds Talk-Back and Dinner (after Lecture)
	September 21, 2018 – Black Quantum Futurism Collective Workshop
	September 27, 2018 – Robby Herbst Workshop
	November 7, 2018 – Urban Bush Women Workshop

Your Information

Name:	First
	Last
Phone Number:
Email Address:
Mailing Address: (optional)
I am an…	OWU Community Member Delaware Community Member Other
If “Other,” please describe:
Number of people I plan to bring with me:	0 1 2 3 4 5 6 7 8 9 10