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Summit for University Center Leaders Registration
Please fill out your information below to register for this event.
Name
*
First Name
*
Last Name
*
Email
*
Email Type
*
Work
Personal
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands (US)
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces (the) Americas
Armed Forces Europe
Armed Forces Pacific
Army Post Office (U.S. Army and U.S. Air Force)
Fleet Post Office (U.S. Navy and U.S. Marine Corps)
State
ZIP Code
Mobile Phone
*
For event communication only. Please only enter numbers.
Three words to describe yourself for your event name badge (get creative!)
*
For example: Floridian, Economist, Runner
Affiliation
Are you affiliated with a University Center?
*
No
Yes
Affiliation
*
Enter your affiliation - If your affiliation does not appear please enter it above.
Title at Center
Are you a faculty member with your University?
*
No
Yes
Title at University
*
Event Information
I wish to be included in the Participant Directory
Yes
No
Dietary Restriction(s)
*
If you do not have any dietary restrictions, please enter N/A
Do you have any special accommodation requests?
I want to receive bi-monthly university center newsletter updates from the Mercatus Center.
Yes
I consent to having my photo taken and used for Mercatus internal publishing.
Yes
By marking a character here you understand and give consent to the Mercatus Center to use the information inputted for event registration. Please check our website https://www.mercatus.org for our privacy policy.
*
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