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2016 Spring Conference Registration - Phi Theta Kappa
Rocky Mountain Cascade Region - Spring Conference - Albany, Oregon - May 20th-22nd
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Attendee Information
Each registrant must submit a separate registration form.
Event Information
Location:
Comfort Suites & Holiday Inn Express
100 Opal Court NE
Albany,OR 97322
541-928-2053
Host Chapter:
Linn Benton Community College
First and Last Name
*
Your answer
Title
*
Advisor
Member
Chapter Officer
Alumni
Guest
Email Address
*
Your answer
College or University
*
Your answer
Phi Theta Kappa Chapter
*
Your answer
Advisor Name
*
Your answer
Advisor Email
*
Your answer
Advisor Phone Number
*
(In case we have questions about your registration)
Your answer
Food Preferences
*
Check all that apply
Vegetarian
Vegan
No Gluten
No Lactose
No Nuts
No Dietary Restrictions
Required
Additional notes on food preferences
Your answer
If you have any accessibility needs, please describe here:
Your answer
Emergency Contact Phone Number
*
Your answer
Name and Relation of Emergency Contact
*
Your answer
Role(s) at This Conference
*
Check all that apply
Participant
Presenter
Volunteer
Required
Is this the first time you have attended a Phi Theta Kappa Regional Conference?
*
Yes
No
Registration
IMPORTANT: If you have not yet registered, you must now pay the late price for registration. Late registration deadline will be May 9th.
Registration Options: Please Choose One
*
We encourage everyone to register for the full conference - both Friday and Saturday. However, to accommodate those with limited schedules, we are offering a second registration option for Saturday only.
Late Registration - All weekend: $85
Late Registration - Saturday Only: $70
Registration Fee Includes:
Conference attendance, conference program and materials, dinner Friday and Saturday evening, and lunch on Saturday. *Note: Saturday Only registration fee does not include Friday dinner.
Payment:
Please send a check (payable to Phi Theta Kappa - Rocky Mountain Cascade Region) to:
Michelle Gietl
Columbia Gorge Community College
400 East Scenic Dr.
The Dalles, OR 97058
The memo field needs to contain a note about: RMC Regional Spring Conference
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