Registration Form

History of Activism, History as Activism

Columbia University, Graduate Student Conference

April 5-6, 2002

 

Last Name:_______________________ First Name:__________________ Middle Initial:_____

Street Address:__________________________________________________________________________

City:_______________________________________ State:________________ Zip:__________________

Email:_______________________ Telephone (Day):__________________ (Evening):________________

Institutional Affiliation:___________________________________________________________________

_______ I plan to attend the Social Hour on Friday evening

_______ I plan to attend the Social Hour on Saturday evening

 

 

 

 

 

 

 

 

Please return this form to:

Department of History
Activism Conference
Mail Code 2527
611 Fayerweather Hall
Columbia University
New York, NY 10027
Questions? Send them to [email protected]
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