Oregon State NCM Fall Retreat 2021

November 5-7 | Fall retreat is November 5-7. We are excited to be able to get together with the NCM's throughout the northwest. Fill out the form to let us know if you are coming! Your local campus director will be in contact with you about a packing list and information about transportation.

Name

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Email

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This address will receive a confirmation email

Phone

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Campus Attending With

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Please select all that apply.

Central Washington University Mt. Hood Community College Portland State University Portland Community College Oregon State University University of Oregon Other

Age

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Gender

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Female Male Other

T-Shirt Size

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Would you be willing to drive to fall retreat?

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yes no

if so, how many can you fit in your car? (including you)

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What is the earliest you can leave on Friday?

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Emergency Contact Info

Name

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Phone

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Relation

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Health Insurance Company

Policy Number

Food Allergies

Other Allergies

Payment 25.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

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Description

November 5-7

Fall retreat is November 5-7. We are excited to be able to get together with the NCM's throughout the northwest. Fill out the form to let us know if you are coming! Your local campus director will be in contact with you about a packing list and information about transportation.

Please Fix the Following

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