Registration Form

Registration Form: 

Please complete the following information to confirm that you are a LGBT graduate of Plymouth State University who would like to be recognized at the annual Lavender Graduation Ceremony held in May.
  • Graduate Information

  • Contact Information

  • Degree receiving (check all that apply)

  • Please enter a value between 0 and 50.
  • Personal Information: PLEASE READ CAREFULLY

    We encourage you to submit a self designed PowerPoint slide with the following information: Name, hometown, picture, campus and/or off campus involvement with LBGT programs/events/services, leadership positions, awards and or/recognitions received at PSU as well as anyone you would like to recognize as a mentor. We also encourage you to send any and all pictures that you may have of your time here at Plymouth State University. These will be part of a slideshow that will be presented during the Lavender Graduation ceremony.
  • In order for you to be included in the slideshow, send PowerPoint slide and pictures as an attachment with this completed form by the MAY 1st deadline, to Delilah Smith @ drsmith@mail.plymouth.edu
    or send to the S.A.G.E. Center at
    17 High St, MSC #43,
    Plymouth NH 03264.

    Thank you and congratulations for all that you have accomplished!
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Hours/Contact

December 17th, 2012 by Michael

Contact us

(603) 535-2387
or
Email Kyle O’Neill at ktoneill@plymouth.edu

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