Senator for a Day Registration Form

Friday, October 23, 2026 | 8:30 am – 2:00 pm

Northampton Community College
Monroe Campus
2411 Route 715, Tannersville, PA 18372

Registration Deadline is Friday, October 2, 2026.

Senator for a Day Seminar

Phone
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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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development
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 Tourism, Recreation and Economic Development