Multicultural Outreach & Recruitment










2019 Shades of Purple Registration

Select Conference Date and Location:*

Your First Name:*

Your Last Name:*

High School:*

Grade:

Date of Birth:*

Your Email:*

Phone Number:*

Cumulative GPA:*

Ethnicity:*

Please specify Tribe:

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What is your interested major?:*

Do you qualify for free/reduced lunch?:*

Are you a first-generation college student?:*

Do you have any dietary restrictions?*

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Parent Permission Form

In order for your application to be complete, a Parent Permission Form must be turned in. If you are requesting transportation Conduct and Liability Form must also be submitted. We recommend you download, sign, and re-upload the forms now. Once downloaded, the form can be signed using software such as Adobe Reader. After signing, save the file and upload it here. If you cannot do this now, you may email the file to reach@uw.edu. Please note: your application will be considered INCOMPLETE without a submitted Parent Permission Form.

Click here to download:

Parent Permission Form


Upload your Parent Permission Form here:


Contact

If you have any questions please contact:
Office of Minority Affairs & Diversity
Multicultural Outreach & Recruitment

1410 NE Campus Parkway
Suite 375, Box 355845, Seattle, WA 98195-5845

Email: reach@uw.edu

Phone: 206.221.6463

To request disability accommodations, contact the Disability Services Office at least ten days in advance of the event:

(206) 543-6450 (voice); (206) 543-6452 (TTY); (206) 685-7264 (fax); dso@u.washington.edu (e-mail)


Submit

Click the Submit Application button if you are ready to submit your application.