*First Name:

*Last Name:

*Banner ID:

Phone Number:

*Email Address:

*I plan to graduate in: Spring 2012Fall 2012Spring 2013Fall 2013Spring 2014Fall 2014Spring 2015Fall 2015Spring 2016Fall 2016Spring 2017Fall 2017Spring 2018Fall 2018Spring 2019Fall 2019Spring 2020Fall 2020Spring 2021Fall 2021

*How did you hear about the program?

*Which area of workplace law interests you the most? (e.g. employment law, employment discrimination law, labor law, etc.)

Have you already completed the online Workplace Law Certificate Application? (http://www.law.du.edu/forms/registrar/workplace-law-cert.php)
Yes
No

Are you interested in learning more about the associated student organization "Employment Law Association" (ELA)?
Yes
No

*Are you interested in attending events, activities and/or programs sponsored by the Workplace Law program?
Yes
No

Additional comments/suggestions: