Senator for a Day Registration Form

Friday, October 25, 2024 | 8:30 am – 2:00 pm
Northampton Community College – Monroe Campus

Registration Deadline is Friday, September 27, 2024.

Senator for a Day Seminar

Advisor(s):

Advisor Contact Number:

Advisor E-Mail Address:

School Name

School District: (For Home School Students)

Student 1
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 2
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 3
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 4
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 5
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 6
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 7
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 8
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 9
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 10
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 11
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 12
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 13
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 14
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Student 15
Student Name:

Committee Choices: Please mark 1st, 2nd and 3rd choices only per student
Transportation Communications and Technology Health and Human Services Education Law and Justice
Name
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