CRWLC Registration form - Kappa Alpha Psi Fraternity Inc.



C. RODGER WILSON LEADERSHIP CONFERENCE

September 15 - 16, 2017

REGISTRATION FORM

Hosted by the Delta Pi (Michigan State University) and Lansing Alumni Chapters

On the campus of Michigan State University, East Lansing, Mich.

CLICK HERE FOR ONLINE REGISTRATION LINK

NAME:

STREET ADDRESS:

CITY: STATE: ZIP CODE:

PHONE: EMAIL ADDRESS:

CHAPTER: ____________________ PROVINCE/CHAPTER OFFICE (If Applicable):________________________

FINANCIAL WITH: (Check all that apply) Grand Chapter Province Local

REGISTRATION FEE: ALUMNI $55 COLLEGIATE $20 Members MUST be Financial to attend.

Mailed Registration/ Fees must be postmarked no later than August 20, 2017

PLEASE DO NOT SEND CASH: CHECKS WILL BE ACCEPTED ON SITE WITH ON SITE REGISTRATION

Amount Enclosed: $ ___________ (checks, drafts, cashier checks, money orders)

Checks should be made payable to: Kappa Alpha Psi – Northern Province and mailed to: Julius Maddox PO Box 07143 Detroit, MI 48207 (313) 850-8607 jamura124@

IMPORTANT NOTE:

Costs noted are good only until August 20th,

afterwards they increase $5 for undergraduates and $10 for alumni.

After August 20th brothers will only be able to register on line or on site.

Registration Fees for Fall 2016 and Spring 2017 MTA INITIATES attending the CRWLC are waived, as they were included in the MTA initiation fee. If you are an INITIATE from the above Intake Sessions and are attending, PLEASE CHECK THIS BOX. Initiates are still required to fill out and send in this registration form.

Hotel Information: Candlewood Suites Room Rates are $95 for a Studio Suite and $135 for a One Bedroom Suite. Brothers must specifically request the Kappa Alpha Psi rate/block of rooms, if calling (517) 351-8181 to set up the hotel reservations.

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download