OFFICE OF DISABILITIES AND COMPLIANCE MOVIE SHOWING CODA (20th OCTOBER)

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* 1. Please enter your ub.edu.bs email address

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* 2. Select all that applies ...

Male

Female

UB Student

UB Admin

UB Faculty

UB Staff

Non Disabled

Disabled

Other (please specify)

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* 3. Are you registered with the Office of Disabilities and Compliance ?

Yes

No

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* 4. Are you interested in attending Black Panther Wakanda Forever II ?

Yes

No

Maybe

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* 5. Do you have accompanied guest ?

Yes

No

If yes, please specify amount and names...

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* 6. I understand and agree to the ODC providing the ticket , a drink and popcorn only ( unless otherwise stated in writing ) during the showing of the movie Coda. I as a participant will be responsible for transportation, additional food and drinks and ownership of my actions and my accompanied guests listed.

Yes

No