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New Mexico State University
Student Leadership Conference

Registration closes November 2, 2012.
On-site registration will be accepted, if space permits.

Name :
University affiliation:

E-mail :

Address :

Phone :


Year in School :

This conference includes breakfast & lunch. Please list any dietary restriction and we will do our best to accommodate. Thank You

Student Organization Membership: (If Any) and Offices Held (If Any)

By submitting this registration, I commit to attending this conference and experiencing it to the Fullest!


You can also print out this form and bring it to
the Office of Campus Activities 235 CCSU