On Loss and What Remains Dialogue Registration NameThis field is for validation purposes and should be left unchanged.Please join us for a tasty meal and facilitated dialogue about a timely topic! DATE: Friday, May 1 TIME: 5–7pm LOCATION: Women’s Resource Center, Student Union EG37Name(Required) Full name Email(Required) Primary role at 51ÁÔÆæ(Required) Undergraduate student Graduate student Faculty or teaching staff Non-teaching staff Alumni or community member Major / Field of StudyInterest in dialoguePlease share briefly why you’re interested in participating in this dialogue and/or what you hope to gain from it.Parking pass?(Required)Will you need a parking pass for on-campus parking? (This can be picked up at the event and used to pay the parking garage fee.) Yes No Accommodations or dietary needs?We value your full participation, so please let us know if you need any accommodations (e.g. ASL interpretation, wheelchair access, etc.). Please also use this space to alert us if you have any food allergies or other dietary restrictions.Commitment to attend(Required)IMPORTANT! Because this event includes a catered meal, we need an accurate attendance count. So if you’re unable to attend, please alert us so we can offer your space to another. I am committing to attend and will alert the organizers if I am no longer able to attend.