RICHMOND DIVERSITY DIALOGUE DAY 2020 SCHOOL REGISTRATION FORM

*This form must be received by VCIC by October 30, 2020*
Please write out the full name of the school
Please include area code
To reach you on the day of the program (include your area code)

PLEASE SHARE THE FULL NAMES OF THE STUDENTS YOU WOULD LIKE TO REGISTER:

All student names and completed permission forms are required prior to the program. If unable to fill in now, contact Tally Botzer prior to October 30 (tbotzer@inclusiveVA.org). If you don't plan to fill all 5 spots, type N/A.

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