Private: Apply to attend the NJSLC Conference!

NJSLC Delegate Application Form 2019

This form should be completed for students who would like to be considered to attend the National Jesuit Student Leadership Conference 2019 held at University of Detroit Mercy from July 10 - 14, 2019. Delegate applications must be completed by March 25, 2019. Delegates will be chosen and notified on or before April 1, 2019. The university will cover the cost of the following for delegates: conference registration, travel, lodging and meals.

Check out the NJSLC 2019 site for more information!

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Name (as it appears on your Driver's license or state ID)

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Gender/Pronouns

Cell Phone Number

Birthdate

Enter Birthdate

Class Year

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T-shirt size

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Emergency Contact Name

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Emergency Contact Phone Number

Please indicate special food needs or allergies.

Summer Address

Address

City

State / Province / Region

ZIP / Postal Code

Country

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Please list campus involvement

Why do you want to attend NJSLC? What do you hope to learn? (Maximum of 500 words).

Have you attended an NJSLC conference in the past? (Preference will be give to first-timers)

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By clicking "Yes" in this box I agree that if chosen as I understand that I will be expected to share what I learn at the conference with others in my organization or on my staff.

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By clicking "Yes" in this box I agree that if chosen as a delegate I will be available to work with the delegation to present an educational session at the conference.

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By clicking "Yes" on this box I understand that if selected to attend, but then have to back out of the conference anytime after May 1, I will have to reimburse the university for the registration and travel costs.

- None -

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