EmailMe Form - 88th Northern Province Council

Name *

First Last

Silhouette Attending

Silhouette Name

First Last

Phone

### - ### - ####

Email

Undergraduate/Alumni Chapter *

Financial With (select all the apply)

Grand Chapter

Province

Local

Alumni Registration Description

Alumni registrations completed during Regular Registration (Apr 19 - May 9) will include a $6.88 processing fee. Summer 19/Fall 19/Spring 20 MTA MEMBERS REGISTRATION FEE WAS INCLUDED IN YOUR INTAKE FEE.

Registration-Alumni *

Undergraduate Registration Description

Undergraduate registrations completed during Regular registration (Apr 19 - May 9) will include a $4.34 processing fee. Summer 19/Fall 19/Spring 20 MTA MEMBERS REGISTRATION FEE WAS INCLUDED IN YOUR INTAKE FEE.

Registration-Undergraduate *

Entree Choices

Please indicate your selections

Undergraduate Luncheon *

Formal Banquet *

Kappa Foundation Breakfast (Optional) *

Occupational Profession *

Regular Registration: Alumni $220.00 - Undergraduate $135.00
Registration and payment MUST be received no later than May 9,2020.

Late/On-Site Registration (Online Only): Alumni $245.00 - Undergraduate $150.00

Registration and payment WILL ONLY be accepted online and must be received no later than June 20, 2020.

***Upon submitting your registration you will receive an email confirmation along with necessary hotel reservation information.***

Payment Acceptance Agreement *

I have read and accept the payment structure as stated above.

Forms of Payment *

Province Keeper of Exchequer Notes Only

**Please Do Not Write In This Space**