Regional Meeting Registration 2010

Exit this survey

 

*

1. Which Regional Meeting will you be attending (you must attend the regional meeting for your region).

Which Regional Meeting will you be attending (you must attend the regional meeting for your region).   Region 1 - Upstate- SUNY Oswego Region 2 - NYC Metro - NYC Region 3 - New England -University of RI Region 4 - Mid-Atlantic -Washinton, DC Region 5 - Midwest - Chicago, IL or Merriville, IN Region 6 - Greater US - Teleconference Call

*

2. First and Last Name

First and Last Name

*

3. Will you be attending as a:

Will you be attending as a:   Chapter President Chapter Delegate General Participant

*

4. What chapter will you be representing if attending as a President or Delegate, or which chapter are you currently active/associated with if attending as a General Participant?

Select One

CHAPTER

Alpha ChapterBeta ChapterGamma ChapterDelta ChapterEpsilon ChapterZeta ChapterEta ChapterTheta Alpha ChapterTheta Beta ChapterTheta Gamma ChapterTheta Delta ChapterTheta Epsilon ChapterTheta Zeta ChapterTheta Eta ChapterTheta Theta ChapterTheta Iota ChapterTheta Kappa ChapterTheta Lambda ChapterTheta Mu ChapterTheta Nu ChapterIota ChapterKappa ChapterLambda ChapterMu ChapterNu ChapterXi ChapterOmicron ChapterPi ChapterRho ChapterSigma ChapterTau ChapterUpsilon ChapterPhi ChapterChi ChapterPsi ChapterOmega ChapterAlpha Alpha ChapterAlpha Beta ChapterAlpha Gamma ChapterAlpha Delta ChapterAlpha Epsilon ChapterAlpha Zeta ChapterAlpha Eta ChapterAlpha Theta ChapterAlpha Iota ChapterAlpha Kappa ChapterAlpha Lambda ChapterAlpha Mu ChapterAlpha Nu Chapter What chapter will you be representing if attending as a President or Delegate, or which chapter are you currently active/associated with if attending as a General Participant?   CHAPTER   Select One

*

5. Do you have any dietary restrictions?

Do you have any dietary restrictions?   Yes No

If yes, please explain.