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56th Southeastern Province Council
Online Registration


Name (Last, First, MI)
Email Address

Address

Chapter

If Chapter Officer, please select position

Telephone Number Home

Telephone Number Work


Official Family Only (Registration Fees Waived)

Select All That May Apply

PROVINCE OFFICERS



Has your hotel reservation been made?


PROVINCE MEETING FEES (SELECT ONE)

EXPANDED REGISTRATION FEES

If you plan on attending the Inspirational Breakfast please make a selection below and include this amount with registration fee - FRIDAY, March 30, 2007@ 7:30 A.M.
NUMBER OF BREAKFAST TICKETS


DELEGATE INFORMATION
If you are registering for your chapter, please submit your delegates names below
NOTE: DO NOT PLACE DELEGATE INFORMATION UNLESS YOU ARE REGISTERING FOR THE ENTIRE CHAPTER!!!


ADDITIONAL COMMENTS



PLEASE REVIEW YOUR INFORMATION BEFORE YOU CLICK REGISTER. YOUR INFORMATION WILL BE ELECTRONICALLY SENT TO BROTHER PARAS GRIFFIN. AFTER YOU CLICK REGISTER, PLEASE FOLLOW THE INSTRUCTIONS ON THE NEXT PAGE, REVIEW YOUR ENTRY, AND THEN CLICK CONTINUE.

Please re-enter your email address for confirmation email address

 

 

 

 

 

 

 

 



 
 
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