PARTICIPANT INFORMATION FORM (PIF)


 
 
TEAM MEMBER:
You must be a U.S. citizen to participate.
Institution/School:
If you have participated in the RGSFOP before, when? Month: Year:
  Role:
Your Last Name:
Your First Name:
Your Middle Name:
Gender:
Date of Birth
(MM/DD/YYYY):
Ethnicity: (opt)
Academic Level:
Major:
Anticipated date of Graduation:
Current Team Role:
Email:
Are you a U.S. Citizen?:
Yes No
 
Only JOURNALISTS should complete the following information
Business Name:
Address:
City:
State:
Zip:
Business Phone:
Fax:
Email:
Type of Media Outlet:
Type of Market:
Type of Employee:
 
 
 
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