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Please complete the following information to register for "Stories or Civic Engagement: Perspectives from Faculty, Community Partners, and Students", a conference sponsored by the Western New York Service Learning Coalition and Hilbert College.

Friday, March 4, 2016
Hilbert College

Online registration ends March 1, 2016.

You may also register in person at the conference
on Friday, March 4, 2016 at 8:30 am.

$50 for WNYSLC Members
$75 for Nonmembers

Membership is by institution and community partner organization. If you do not know if your institution/organization is a member of the coalition, please check the member listing on the WNYSLC website.

* = Required

There is a 20% discount for conference presenters

Please check if presenting

Partial and full scholarships may be available for students and community based organizations.
Priority will be given to conference presenters.
Please check here if you would like to apply for a scholarship.
Full Scholarship
Partial Scholarship
**You will be contacted by telephone or email if have applied for a scholarship.

* First Name:
* Last Name:
* Job Title:
* Institution/Organization:
* Address 1:
Address 2:
* City: * State: * Zip:
* Email:
* Phone Number:

I have been involved in the community through (check all that apply):
Service Learning
Community Based Participatory Research
Volunteerism/Community Service

My primary role at this conference would be as:

Have you attended a WNYSLC Conference in the past?:

Please tell us how you heard about the conference:

: How other?

Please check if services for persons with disabilities are requested.
What type of accommodation is needed?

* Registration Type:

* Payment Method:

Checks should be made payable to Niagara University and mailed to:

Niagara University/WNYSLC
PO Box 1906
Niagara University, NY 14109-1906

Please write WNYSLC Conference in the memo line if possible.

All requests for cancellations and refunds must be in writing. No refunds after March 1, 2016. There will be a $20.00 handling fee for cancellations. Questions? Call Marilyn Fleckenstein, 716.783.7133 or

Registration fee includes breakfast and lunch.

Do you have special dietary requirements? Please describe.

Updated: January 2016