ITASA Mid-Atlantic Leadership Retreat Registration

First Name *

Last Name *

Gender *

Male
Female

School *

Johns Hopkins University
University of Maryland - College Park
Georgetown University
University of Virginia
George Washington University
University of Maryland - Baltimore County
University of Delaware
Other:

Email Address *

Phone Number *

Date of Arrival * The leadership retreat takes place from November 13th-15th. The actual day of the retreat is Saturday, November 14th. If you arrive on the 14th, please arrive by 10am.

Friday, November 13th
Saturday, November 14th

Housing * If you select "Yes", you will be hosted by a student at Johns Hopkins. If you select "No", no housing will be provided. Housing is free, though limited spaces are available.

Yes
No

Payment * The cost of attendance is $16. This will cover breakfast, lunch, an afternoon snack, and the cost of leadership retreat supplies. Payment is available in person or online. Please select how you would like to pay

Online
In person