Culture Champions Network

CCN Registration Information
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1. first name (preferred)

2. last name

3. UM email address

4. phone number

5. role at UM
                
6. Primary campus or location
                
7. If you are a student, what is your class level?
                
8. Please select all statements that apply to you:
         
            I am an international student
            I am a commuter student
            I am a first generation student
            I transferred to UM from another university
            I am a military veteran or active duty service member in the U.S. or in a country other than the U.S.
            None of these statements apply to me
      
9. Please list all UM student organization categories with which you are affiliated as a student, faculty or staff member (check all that apply):
         
            Religion, Spirituality, Performing Arts
            Programming Board
            Greek Life
            Health & Wellness
            Multicultural & Identity-Based
            Media & Publications
            Communities
            Community Outreach & Social Change
            Club Sports
            Academic, Honorary, & Professional
            Not applicable
      
10. School affiliation (check all that apply):
         
            School of Architecture
            College of Arts and Sciences
            Miami Business School
            School of Communication
            School of Education and Human Development
            College of Engineering
            School of Law
            Rosenstiel School of Marine and Atmospheric Science
            Miller School of Medicine
            Frost School of Music
            School of Nursing and Health Studies
            Division of Continuing and International Education
            Graduate School
            Not applicable
      
11. Business office affiliation (check all that apply) :
         
            Board of Trustees
            Office of the President
            Academic Affairs & Provost
            Advancement & External Affairs
            Athletics
            Business & Finance
            General Counsel
            Government & Community Relations
            Hemispheric and Global Affairs
            Miller School of Medicine-clinical
            Miller School of Medicine-marketing
            Public Affairs and Communications
            Student Affairs
            UHealth
            Not applicable
      

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