PLCer Contact InformationYou must have JavaScript enabled to use this form.Indicates required field Name (Last, First)Preferred First Name (Nickname)Please indicate what you prefer as your first name - this is for face-to-face purposes and your formal PLC namebadge (example: Teddy instead of Theodore)Your Pronouns her/hers/she he/him/his they/them/theirs ne/nem/nirs/nirs ze/zir/zirs other - I will tell you in person when I am readyPlease indicate the pronouns you use so we can best learn how you identifyIntended MajorPlease enter your intended major at CU Boulder. If it has changed since your application, we want to know your NEW choice!Email AddressPlease enter the email address you are most likely to check this summer.Cell Phone NumberBirthdayDietary Restrictions/Food AllergiesPlease list your required food restrictions or allergies (not just preferences). If these are life threatening, please indicate so. If you have none, please just enter "N/A."Dorm Name or Living LocationPlease let us know the dorm you will be living in this academic year if you know your assignment. If you do not yet know, please enter 'Not yet assigned.'Mother/Guardian Name and emailPlease enter the name and email of your mother/guardian. If this person is not in your life, please enter "N/A."Father/Guardian Name and emailPlease enter the name and email of your father/guardian. If this person is not in your life, please enter "N/A."Digital Photo/Head ShotPlease upload a photo of yourself for the PLC scholar board. This can be a head-shot, senior photo, or another photo you prefer. Please no family or group or party photos.One file only.2 MB limit.Allowed types: gif, jpg, jpeg, png.
