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Walla Walla 509.527.4351 | Clarkston 509.758.1567 | [email protected]500 Tausick Way Walla Walla, WA 99362

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Walla Walla Community College

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SGA
Student Activities
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Clubs & Orgs
Intramurals

Students of Color Conference

Full Name*
Preferred Name
Cell Phone Number*
WWCC Student Identification Number*
How do you ethnically/racially identify?
What is your gender identity?
I take most of my classes on:*
- The Walla Walla Campus
- The Clarkston Campus
- Online
Best form of communication to reach me:*
- Phone Calls
- Texts
- Email
- Other
Phone Number*
Email*
If other, please specify*
What do you hope to gain from attending the Students of Color Conference?*
Dietary Needs*
- Vegetarian
- Vegan
- Other
Please specify*
Please mark preferred caucuses that you would like to attend*
- African American/Black
- Asian American
- LatinX
- Native American/Indian/Alaskan Native
- Biracial/Multiracial
- African Diaspore
- International
- White
- Middle Eastern/South Asian
- Pacific American Islander
Please mark identity development that you would like to attend*
Space is limited in Identity Development Workshop. Only students who identify with the workshop topic should attend. Other students may use this time for networking.
- Women's Identity
- QTPOC
- Dreamers
- Muslim
- Students with Disabiliites
- Men's Identity
Please describe any disability-related accommodations you would need in order to participate in the conference
Emergency Contact Information*
Name Relationship Telephone Number
Did you attend last years Students of Color Conference?*
- Yes
- No
How did you apply what you learned to make WWCC and your community a better place?*
1. By committing to attend the 2019 Students of Color Conference (SOCC), I agree to:
- Receive permission from my instructors to miss class Thursday, April 18th and Friday, April 19th
- Complete homework ahead of time and make arrangements for tests/quizzes
- Notify my place of employment and take the time off of work from April 18-20
- Notify Nadine Barragan immediately (509.527.4259 or [email protected]) if an emergency situation arises and you are no longer able to attend.
2. If selected to attend, I agree to read and sign all forms associated with this conference. Below is a sample list of forms that were filled out last year:
- WWCC Release Form & Code of Conduct
- Student Medical History
- Risk Liability Form
- SOCC Pre-conference Survey
- SOCC Photo Release Form
- SOCC Student Conduct Policy Acknowledgement Form
3. Travel & Hotel
- Conference Costs (food, hotel, conference, travel) will be covered by WWCC Foundation.
- Bring the necessary supplies, clothing and belongings for travel.
- Be ready to leave the Walla Walla campus by 8 AM on Thursday, April 18,, with an anticipated return to the Walla Walla campus on Saturday, April 20 at about 3 PM.
- Transportation will also be provided from the Clarkston campus. Details TBA.
- Conference participants that choose to provide their own transportation, or are unable to take advantage of the provided transportation, will do so at their own expense.
- All attendees will be paired with a roommate.
4. Review of Applications
- Space is limited to 10 Walla Walla Community College Students
- All applications will be reviewed by March 14th, and each candidate will be contacted by March 15th.
*
- By checking this box, I agree to the commitments listed in this document and, if selected to attend, I agree to read and sign all forms associated with this conference.
Name*
Date*

Walla Walla Community College

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