CAMPUS PLUG ACCEPTANCE FORM Name * First Name Last Name Date of Birth * MM DD YYYY University * Brown University Columbia University Cornell University Dartmouth College Harvard University University of Pennsylvania Princeton University Yale University Degree Level * Undergraduate Graduate Undergraduate and Graduate Class Year * Major / Minor * Email * Phone * Country (###) ### #### LinkedIn URL * http:// Instagram URL * http:// Heritage / Nationality (e.g., African-American, Jamaican, Kenyan, etc.) * What is your dream aspiration? * Why do you want to join BlackIvy? * Dietary Restrictions * Gluten-Free Halal Kosher Nut-free Pescatarian No Dairy No Eggs No Fish No Seeds No Soy Vegan Vegetarian None Other If answered "Other" above: Please indicate your dietary restriction(s) T-Shirt Size * XS S M L XL XXL 3XL 4XL Hoodie/Crewneck Size * XS S M L XL XXL 3XL 4XL What are 3 skills you can add to the team? * Committee Member 1 Full Name * Committee Member 1 Email Address * Committee Member 1 Phone Number * Committee Member 2 Full Name * Committee Member 2 Email Address * Committee Member 2 Phone Number * Committee Member 3 Full Name Committee Member 3 Email Address Committee Member 3 Phone Number Thank you! We will be in contact regarding next steps.
