Introductory Symposium

First name

Last name

Email

Email should be one that you check regularly. All of our communications will be via email.

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

High School

You must go to school in Suffolk County. If you do not, you must prove that you live in Suffolk County through your home address.

I am a SENIOR

Yes

Guidance Counselor Name

Guidance Counselor Email

Guidance Counselor Phone Number

I would like to attend the In-Person Symposium

Yes

Wednesday, October 28th

6:30 - 8:00 PM

Hauppauge Public Library

1373 Veterans Memorial Highway

Hauppauge, NY 11788