2017 Fall Conference Registration - Phi Theta Kappa
Rocky Mountain Cascade Region - Fall Honors in Action Conference- Roseburg, OR- October 20th-22nd
Attendee Information
Each registrant must submit a separate registration form. An invoice will be sent to your chapter advisor.
Event Information
Friday October 20th- Sunday October 22nd

Tentative schedule:
Friday- Registration at 4:00 pm. Dinner and activities 6:00 pm-9:00 pm
Saturday- The full day is typically 8:30 am-5:00 pm, dinner around 6:00 pm. Evening activities.
Sunday- We have our regional meeting, we encourage everyone to attend. It will be in the morning. Time and location to be determined.

Registered attendees will receive an agenda about a week prior to the conference. There will be directions to UCC and other important information.

Hotel Information:
Here is some information on the local hotels. The Sleep Inn & Suites and Holiday Inn Express, both serve free breakfast in the morning. We do not have room blocks. These are the two hotels that we recommend.

Holiday Inn Express Roseburg
Address: 375 W. Harvard Blvd., Roseburg, OR 97470
Phone: (541) 673-7517

Sleep Inn & Suites
Address: 2855 NW Edenbower Blvd, Roseburg, OR 97471
Phone: (541) 464-8338

Conference Location:
Umpqua Community College

Roseburg, OR

(Building location and maps will be emailed to all attendees about a week before the conference.)

Host Chapter: , Umpqua Community College (Alpha Sigma Upsilon)

First and Last Name *
Your answer
Title *
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
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
Is this the first time you have attended a Phi Theta Kappa Regional Conference? *
We are only charging one rate for registration this year. Registration deadline is: Saturday October 14th.
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, at the same price.
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.
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 Fall Conference

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