Please provide us with the following information to register for the 2005 Langone Retreat.
Required fields are indicated with an
*
Indicate N/A where Applicable
Participant details
Type of Registrant
*
Member of Langone Community (student, alum, faculty, staff, admin)
Guest
First Name
*
Last Name
*
Nickname
NYU Id
*
(e.g.pl491)
Street Address 1
*
Street Address 2
City
*
State
*
Zip code
*
Primary Email
*
Primary Phone
*
Cell
Home
Work
Alternate Phone
*
Home
Cell
Work
Academic/Professional details
Status
*
Incoming LangoneStudent
Continuing LangoneStudent
Langone Alum
Stern Faculty/Staff/Administration
Core Group
*
N/A
2000 Fall Blue
2000 Fall Green
2000 Fall Orange
2000 Fall Purple
2000 Fall Red
2000 Fall Yellow
2001 Spring Green
2001 Spring Red
2001 Spring Yellow
2001 Fall Blue
2001 Fall Green
2001 Fall Orange
2001 Fall Purple
2001 Fall Red
2001 Fall Yellow
2002 Spring Blue
2002 Spring Orange
2002 Spring Purple
2002 Fall Blue
2002 Fall Green
2002 Fall Orange
2002 Fall Purple
2002 Fall Red
2002 Fall Yellow
2003 Spring Green
2003 Spring Red
2003 Spring Yellow
2003 Fall Blue
2003 Fall Green
2003 Fall Orange
2003 Fall Purple
2003 Fall Red
2003 Fall Yellow
2004 Spring Green
2004 Spring Red
2004 Spring Yellow
2004 Fall Blue
2004 Fall Green
2004 Fall Orange
2004 Fall Purple
2004 Fall Red
2004 Fall Yellow
2005 Spring Green
2005 Spring Red
2005 Spring Yellow
2005 Fall Blue
2005 Fall Green
2005 Fall Orange
2005 Fall Purple
2005 Fall Red
2005 Fall Yellow
Other
Graduation Year
(Expected)
Job Title
Current Employer
Current Industry
Automotive
Banking &Financial Services
Biotech &Pharmaceuticals
Chemicals
Construction &Engineering
Consumer Goods
Distribution
Education
Electronics
Energy & Utilities
Food & Beverage
Government
Healthcare & Medical
Hospitality & Travel
Information Technology
Insurance
Logistics &Transportation
Manufacturing
Media & Entertainment
Retail
Telecommunications
Other
Interests/
Hobbies
Include the above information in the 2005 Langone Retreat Handbook?
Yes
No
Participant preferences
Departure Time
*
6:00 PM, Stern School of Business
Will get there myself by 8:30 PM
Type Of Cabin
*
No Preference
Same Sex
Co-Ed
Early/Late Cabin
*
Early
(quiet after 11pm)
Late
(potentially never quiet)
Dietary Restriction
*
None
Vegetarian
Other
If Other,
Please Specify
Which member of Stern’s faculty/staff/administration would you like us to invite to the Retreat?
*
Saturday classes
Will you be attending Saturday classes at NYU?
*
Yes
No
If Yes, specify Saturday class schedule
Select one
9:00 AM - 12:00 PM
1:00 PM - 4:00 PM
9:00 AM - 4:00 PM
Additional information
Site design copyright 2005 © Langone Retreat, All Rights Reserved
