2012 MALANA Orientation
Registration Form
August 18-20, 2012

Please submit this form by August 3, 2012.

  YES, I will attend MALANA Orientation.
Estimated time of arrival:

  NO, I cannot attend MALANA Orientation

  I play a fall sport and will not be able to attend all of the MALANA Orientation sessions due to practices, but I would like to participate as my schedule allows.

  I live six hours or more from Illinois Wesleyan University. I would like to arrive on Friday, August 17, 2012.

Your Name: 

Parent/Guardian Name: 

Address: 

City, State, Zip: 

Home Phone: 

E-mail Address: 

Number attending Saturday's luncheon @ 12:00nn (limit is 4 including you): 


If you have questions, please contact the Office of Multicultural Affairs at (309) 556-3412.

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