KARH 2017 Registration
Each delegate and advisor will need to complete this form before payment can be accepted. The Early Bird price (Nov 18 - Dec 31) is $100 per delegate (a maximum of 12 delegates per institution please) and $135 per advisor. The late registration fee (January 1 - January 13) will increase by $20 per person. If paying by debit or credit card, please go to this link after completing registration: http://bellarminetickets.universitytickets.com/user_pages/event_listings.asp and Login as a Guest User. If paying by check, please make check payable to Bellarmine University and mail it to Residence Life Office in the attn of Angela Roby at Bellarmine University, 2001 Newburg Rd, Louisville, KY 40205.
Name of Institution
Your answer
First and Last Name
Your answer
Email Address
Your answer
Phone Number
Your answer
Shirt Size
Your answer
Position
Your answer
Name of Emergency Contact
Your answer
Emergency Contact Phone Number
Your answer
Relationship to Emergency Contact
Your answer
Food Restrictions
Your answer
Roommate Preferences (Delegates are 4 to a room and Advisors are 2 to a room. Any advisor wanting a single room may request one at an additional fee. Conference Committee will reach out to you via email if you choose a single room as an option.)
Your answer
How many vehicles will your institution be bringing? (If unsure, please type "unsure.")
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms