You Are About To Register For The Following Event
IPCR Information Session
Date:
1/23/2013
Time:
4:00 PM - 6:00 PM
Event Registration Form
Fields marked with an (*) are required fields.
*
First Name:
*
Last Name:
*
Email Address:
*
Phone Number:
*
Address 1:
Address 2:
*
City:
*
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
*
Zip/Postal Code:
*
County:
Select
Bachelor's degree granted from:
Year of Graduation:
*
I am interested in (check all that apply):
Master's Degree program
Graduate Certificate in Peace Education
Graduate Certificate in Conflict Management and Restorative Justice
Dual Degree option: Master of Public Health
Dual Degree option: M.A. in Counseling Psychology with a Trauma Concentration
Dual Degree option: M.A. in International Relations and Diplomacy (Paris, France)
Semester I plan to enter:
Select
Fall
Spring
Year I plan to Enter:
Select
2013
2014
*
Number attending (including myself):
*
How did you hear about this session?
Online Search
Email
Radio
Referral (word of mouth)
TV
Other
*
If "Other," please specify:
After you click "SUBMIT," you will be asked to review your information before it is submitted to us.
Untitled Document