Student Life Catalyst Leadership Program

Applications for the Catalyst Leadership Program are only available to those students who received a nomination. Catalyst takes place on Saturday, November 10, 2012 from 9:00am - 5:00pm in the Park Hall Multipurpose Room.

Once you enter your information, be sure to click SUBMIT.

Items with an * indicate a required field.

First Name *
Last Name *
BSU ID# *
Local Address *
Zip *
Cell Phone *
Email *
Major *
Indicate your class standing: *
Please list the type of organization you are representing: *
Are you a vegetarian? *	Yes No
Please list any dietary restrictions or food allergies:

Do you require any other accommodations?

Please provide contact information for someone close to you in case of an emergency. Be sure to include first and last name, telephone number, and relationship to you (i.e. parent, sibling, significant other, etc.): *

Please check the box signaling you understand the registration policy below. *	Yes

I am registering to attend the Catalyst Leadership Program. I understand that this program is free of charge; HOWEVER, if I later decide I cannot attend and I fail to notify meisaacs@bsu.edu by Friday, November 2nd, the Office of Student Life will charge my bursar account $50.00 to cover the cost of the program. I also understand that I can contact Mitch Isaacs at 765-285-2621 if I have any questions.