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Fall 2015 Student Success Conference

Complete this registration for the Fall Student Success Conference. PPCC encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact our office at 719-502-3333 or OASIS@ppcc.edu at least 3 business days before the event.

Background Information

Please include your name and contact information. Note that name should be entered last name first and email address should be college assigned student email.

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Full Name:

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Last name, First name

Your position/title:

Your Phone Number:

Your Email Address:

Email address must be of a valid format.

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Student email

Your Physical Address:

Time of incident:

Specific location:

Tell us about you?

PPCC Student Number

Involved party 1

S# Number

Available Workshops

Please choose one workshop per session in order to have right materials available ready for you.

Select which workshop you plan to attend. Session #1 9:10am- 10:10am(Required)

Green Ninja Training In Her Shoes What's Your Slope? Diffusing Hostile Situations AAA: Advocate for Access to Achieve

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Select which workshop you plan to attend. Session #2 10:20am-11:10am(Required)

Health and Wellness Healthy Relationships Engaging Your Support Tech-Know Party Nutrition on a Budget Active Shooter Houston, We Have a Test

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Select which workshop you plan to attend. Session #3 11:20am-12:10pm(Required)

Who Owns Your Education? Getting Engaged CCampus Orientation In Her Shoes Don't Just Test, Celebrate Your Knowledge

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Four-Year Colleges and Universities Meet & Greet. Please indicate yes or no.(Required) This field is required.

Will you be attending the Lunch?(Required)

Yes No

This field is required.

Do you have Dietary Restrictions?(Required)

Gluten

Diary

Shellfish

Peanuts

Other

None

You must make at least one selection.

Submission

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