2018 KOWIN Networking and Mentoring Luncheon Registration
Email address *
Please check here if you don't want your email to be listed in public.
First Name *
Your answer
Last Name *
Your answer
Street Address *
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City *
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State *
Your answer
Zip Code *
Your answer
Phone number *
Your answer
Consent for photography/authorization for publication: If you agree to the following terms, please select, "I agree". *
I, an attendee of 18 years of age or older, or as a parent or legal guardian of attendee(s), hereby give my consent to KOWIN Chicago Chapter for photography, filming, videotaping and/or audio recording or other means of capturing the attendee's/attendees' image(s) or voice(s) and/or being quoted in the media or printed materials, including social media websites, as deemed proper by KOWIN Chicago Chapter.
Age *
Are you currently a student? *
If you currently are a student, please tell us what grade you are in.
School
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Occupation
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Company/Organization
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Choose one area of interest for the mentoring session.
Please specify if you have any dietary restrictions ie. food allergies, vegetarian, vegan, etc. *
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How many tickets would you like to purchase and/or donate? *
Please enter "0" if you are a sponsoree. General admission is $65. Student price is $25.
Your answer
If you are sponsoring someone, please list their name(s). If you are a sponsoree, please list your sponsor's name. *
Your answer
Total amount *
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Method of payment. *
Your contribution is tax-deductible to the extent allowed by law. Please make sure you select "Submit" to get a confirmation email and complete your registration.
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