Peaceful Demonstration Registration

Indicates required field
Name of Group
Date and Time of Demonstration
Date and Time of Demonstration: Date
Date and Time of Demonstration: Time
Rain Date and Time
Rain Date and Time: Date
Rain Date and Time: Time
Location
Subject or Objective of Intended Demonostration
Projected Number of Attendees

Point of Contact Information

Name of Group Representative
First Name
Last Name
RIN
Telephone Number
Address
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Letter of Intent

Please submit an official letter of intent with this application.
Letters of intent should include, but are not limited to:

  • The events purpose and overarching goals
  • The intended time, location, and procession of events
  • An outline how the maintenance of public order will be maintained throughout the duration of the event as not to disrupt the learning environment
  • Identify requests for support from the Dean of Students Office for a successful peaceful demonstration
One file only.
5 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
25 MB limit per form.
Acknowledgement of the Review of Institute Rules and Regulations

Please take time to review the Rule for Maintenance of Public Order found in The Rensselaer Handbook of Student Rights and Responsibilities.

By checking this box you agree to all the terms stated and agree to comply by all the rules and regulations outlined within The Rensselaer Handbook of Student Rights and Responsibilities.

Please take time to review the Rule for Maintenance of Public Order found in The Rensselaer Handbook of Student Rights and Responsibilities.

By checking this box you agree to all the terms stated and agree to comply by all the rules and regulation outlined within The Rensselaer Handbook of Student Rights and Responsibilities.

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