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Send us your Diversity Event details.  
Your Email:
Your First Name:
Your Last Name:
Your phone number (please include area code):
Select your PBCC/academic status:
Select the type of Organization:
The name of your Department/Organization/Club (please do not abbreviate):
The name of your event or service:
Please enter the date your service or event begins:
Please enter the date your service or event ends:
Will the event or service be on an PBCC campus? yes no
If so, which one?
Please provide the name of the contact person for the event or service:
Please type in her or his phone number (please include area code):
Please type the location of the event or service:
Street:
Building:
Room:
City:
Please describe the service or event in the box to the right.

Be sure to include the time of day of the event (if applicable).