Eastern Regional Leadership Conference Registration Form – Chi Sigma Chapter

Eastern Regional Leadership Conference Registration FormWill Mitchell2016-08-17T11:25:22-04:00

First Name*
Last Name*
Address*
City*
State*
Zip*
Phone Number*
Email*
Chapter*
State of Chapter*
Conference Choice*
- Northern Conference
- Southern Conference
Requiring Lodging*
When you click Submit - you will be directed to PayPal. The listed prices are as follows:
Collegiate Registration ONLY - $20.88
Alumni Registration ONLY - $31.75
Collegiate Registration + Bus Transportation - $41.46
Alumni Registration + Bus Transportation = $51.75

NOTE: Your registration will not be COMPLETE until your payment has been received.
Phone
This field is for validation purposes and should be left unchanged.

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