DisRes Current Student Information Request - Fall 2009

Dear Current DisRes students

Please complete all fields in the below form.

With your permission we will post your photo and brief bio on the DisRes Current Students website at http://www.disres.umb.edu/student-profiles.php, and in other promotional materials.

Please email your photo as a .jpg attachment to disres@umb.edu; contact 617-287-7489 with any questions.

NOTE: We will not share your contact information outside of the faculty and staff of the college without your permission; Please use the field below to give your permission to share your email address, and phone number, with your fellow students as well.

Thank you.
Graduate Programs in Dispute Resolution, UMass Boston McCormack Graduate School

* Required

First Name *

Last Name *

I have emailed my .jpg photo to disres@umb.edu Date, please

I give permission to post my bio and photo on the DisRes Website and in other promotional materials * Yes or No or Other: Comments

Brief Bio * include previous degrees, schools, interests, current employer/work experience, experience related to current course of study, professional associations, journals, etc.

Preferred Phone *

Preferred email *

I give my permission to share my contact information with my fellow students * please check pertinent box(es) or use Other: comment

email address
phone number
Other:

Current Street Address *

Current City *

Current State *

Current Postal Code *

We would also like to know how you found the DisRes programs. Referred by? websearch? other?

Please list the Department and Course # for any electives you are taking this semester outside of the Dispute Resolution program Example: Critical Thinking CCT601