Participant Registration Form
MSLC will be taking place from 9:00am-5:00pm on Saturday, January 25th, 2014. This is an amazing opportunity to learn about different forms of leadership, develop your own leadership skills, meet new people and get inspired! All Memorial students are welcome to apply!  Please feel free to email with any questions.
Name: *

Student Number: *

What is your program of study?: *

What year of study are you in?: *

Do you have any allergies, disabilities, or health issues that we should be aware of? *

Do you have any dietary requirements or food allergies?: *

What is your email address?: *

If you have an alternate email address that you would like to use as your contact, please provide it: *

MSLC aims to recognize and reward student leadership while further developing existing and emerging leaders. The conference aims to  promote social networking opportunities and provide students with the opportunity to gain skills and information regarding various forms and examples of leadership. What are your personal expectations for this conference? How can we help meet those expectations? *

As part of the conference this year, we will be facilitating a World Café. This is a café-style discussion about issues related to leadership. This year, we have three (3) options for themes for the World Café. Please select your preference for this session's theme:

Do you have any suggestions for the planning team for MSLC 2014? *

Do you have any un-answered questions or concerns about the conference? Please list them here.

Answers sends out a weekly listserv with information about activities, job opportunities, volunteer opportunities, seminars, and different things happening across campus and the community. Would you like your email added to this list? *

Thank you for your application! We will be emailing you in the coming days with additional information about the conference. Feel free to contact us at in the meantime.
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