Shadow on Concrete Wall

Registration 

January 31, 2022

Registration Closes

Register Here

Registration Form will Ask for the following

Page 1

  • Name

  • Phone Number

  • Email Address

  • Institution

  • Campus Shipping Address

  • Would you like to opt-in to purchasing pins?

Page 2

  • Name of Advisor

  • Preferred Phone

  • Pronouns

  • Phone Number

  • Email Address

  • Accommodation Needs

Page 3

  • Name of Delegate

  • Preferred Phone

  • Pronouns

  • Position

  • Phone Number

  • Email Address

  • Accommodation Needs

Payment Options

Check Payments

Make all checks payable to UC Regents. If possible, please include PACURH RBC 2022 in the memo line. Please include a copy of your invoice with your check when mailing. 

Mail Check To