Washington State University
University Recreation
Program Intake Form
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Exercise.wsu.edu
UREC Program Intake
Contact Information
First Name
Last Name
Email
Phone
Alternate Phone
Group Information
Group Name
Phone
Legal Billing Address
Zip / WSU Mail Code
ID
WA
WSU Building
WSU Room
We are:
WSU Student Group
WSU Staff or WSU Other
WSU Acedemic Group
Other Group Type
Group Definitions
Please tell us the number of people in your group:
Please describe what type of group you are: