Sigma Zeta National Convention Chapter Registration Form

Sigma Zeta National Convention Chapter Registration Form

2012 National Convention
March 29 - 31, 2012
Malone University
Canton, Ohio

Please submit your chapter convention registration form electronically using the form below no later than March 9, 2012 or as soon as possible thereafter. Please submit only one registration per chapter.

If needed look up your Chapter Name for the Chapter Name entry below.

Chapter*

School*

Chapter Advisor/Contact Person:

Name*

Email:*

Phone:

Address

City

State

Zipcode:

Attendee Information:

Number Attending:

Number Students Attending:

Number Faculty Attending:

Total Number Attendees:

Number Presenting:

(Please submit an abstract form for each presenter/poster.)

Please list all members attending (First Last, First Last....) as well as any special physical or dietary needs:

Convention Attendee List:*

Registration Fee: ($25.00/person attending - Make Checks Payable to the Hosting University and place Sigma Zeta on the memo line of the check. Fees can be paid in advance by mailing to the Convention Host or can be paid during registration.)

Registration Fees ($25.00 X #attendees): $

Planned Arrival Time:

Arrival Date (mm/dd/yy)

Arrival Time (hh:mm am/pm)

Travel Plans: How will you travel to this year's National Sigma Zeta Convention

By Plane

By Car

By Van

Other

Field Trip Information and Links

Number Participating in Field Trip

Option1: Cleveland Zoo Cost: $5.00

Trip 1

Option 2: Great Lakes Science Center Cost: $6.00

Trip2

Option 3: Cuyahoga Valley National Park (Hiking) Cost: Free

Trip3

Option 4: Pro Football Hall of Fame Cost: $21.00

Trip 4

After submitting you should receive a confirmation page and also a confirmation email.

Mail a printed copy of the above form (or your confirmation) and payment (Check made out to Malone University. Please include Sigma Zeta on the memo line on the check. ) to:

David Hahn
Malone University
3600 Cleveland Ave NW
Canton, OH 44709
Phone: 330-471-8290