2020 Preamble Institute Delegate Registration
This form is for the required Charge delegate to the 2020 Preamble Institute. Please complete the form in full. You will be contacted by John Lowry to book your travel, this will happen within a few weeks of completing the form. You can contact Brother Lowry at 800.999.1847 ext. 2 proactively to book your travel to the event.
Full Name *
Your answer
Charge *
Birth Date
MM
/
DD
/
YYYY
Delegation (Usually four years from your first year of school) *
Your answer
E-mail *
Your answer
Phone (Mobile) *
Your answer
Select a Travel Option
Confirm Registration: I acknowledge that if I fail to attend and fully participate in the 2020 Preamble Institute (New Brunswick, NJ, 01-17-19 to 01-20-19) my Charge will be responsible for repaying the Grand Lodge the full cost of attending (lodging, flight, etc.) *
Substance Policy: I understand that the Preamble Institute is an alcohol and substance free weekend and that in violating this policy I will not be reimbursed for my travel costs and will be billed for my cost of attending or I will be billed for my travel cost and the cost of attending if travel has already been paid for. *
Dietary Requirements and other Accommodations: Please list any food allergies and dietary requirements. You may also use this space to request additional health or mobility accommodations.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Theta Delta Chi. Report Abuse
Google Forms