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Convention Registration Form 

Please complete this form and submit it by March 15, 2006.  You can (preferably) submit this report on-line by completing this form  or you can mail a print copy (ConventionRegistrationForm2006.pdf) to the Executive Secretary. If you submit this form on-line, please pay with Paypal using the link at the end of this form or mail payment by check enclosed with a print-out of a copy of this form to the address below. If you have more than ten people attending, please submit a second form with the additional names. If you use a print copy, please print or type each name clearly and do not forget to include payment.  Thank you for your cooperation.

Chapter: Institution:

Name & E-mail of Chapter contact:

Registrant Names (add attachment, if necessary): 

1) 2) 

3) 4)

5) 6) 

7) 8)

9) 10)

No. of Vegetarian Meals:

Total Number of Registrants (please add $2.00 if using Paypal):        @ $45 each = $

Late Registration Fee (postmarked after 3/15/06)                          @ $10 each = $

                                                                                               TOTAL ENCLOSED: $

 

 

Please send a copy of this form along with ONE check, made payable to Eta Sigma Phi. OR pay by Paypal by clicking here (no Paypal account required, and be sure to follow the above method of payment):

(We are new to using Paypal, if there are any problems using Paypal through this site, please report your problem to Tom Sienkewicz: toms@monm.edu.  We apologize in advance for any bugs not yet worked out.)

 

NB: No refunds for registration fee after 3/15/06.  

Return this form by 3/15/06 to: 

Thomas J. Sienkewicz, Executive Secretary
Eta Sigma Phi
 Department of Classics
Monmouth College
700 East Broadway
Monmouth, IL 61462

t. 309-457-2371

f. 630-839-0664

e-mail. toms@monm.edu  

Questions? Comments? Contact:

Prof. Terry Papillon

Eta Eta Chapter at Virginia Tech

Terry.Papillon@vt.edu

 

This page is maintained by the Executive Secretary of Eta Sigma Phi, Professor Thomas J. Sienkewicz of Monmouth College. If you have any      questions about this page, you can contact him at toms@monm.edu.