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What is your name?
   
 
 
 
When will you graduate? (Month and Year)
   
 
 
 
What is/are your major(s)/minor(s)?
   
 
 
 
What other organizations within Smith are you affiliated with?
   
 
 
 
What organizations outside of Smith are you affiliated with?
   
 
 
 
Where did you attend high school? (For the sake of our high school initiative)
   
 
 
 
What makes you diverse? How can you add value to DEC and the Smith community?
   
 
 
 
Please list your phone number, email address and any other contact information you would like to provide:
   
 
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