Spring 2018 Student Registration Form
Two - Step Registration Form :

1. You must purchase a ticket before using this form to register. If a firm is sponsoring you, please bring an email confirmation as a form of payment to the ticket purchasing table to receive a receipt number. Only cash or checks are accepted at the table.

2. Please fill out the contents of this form accurately, as it will be used to create YOUR name badge for the event. All information will be verified. Thank you for your interest in CSUN's Award's Banquet.

Location:
The Castaway Restaurant
1250 East Harvard Rd.
Burbank, CA 91501-1096

Date: April 25, 2018

Time of Event:
6:00 pm - 9:00 pm

Student Check-In:
5:00 pm

Email address *
Receipt Number *
Your answer
If paying by check, please enter the check number below:
Your answer
Amount Paid: *
Your answer
First Name: *
Your answer
Last Name: *
Your answer
Your CSUN E-mail Address: *
Your answer
Your Mobile Number: *
Please respond using this Format: (888)888-8888
Your answer
Select your Major: *
Club Affiliation: *
Required
Are you an Executive or Director? *
Name your Position (s)
If involved in more than one club please use this format to describe your position: Club Name 1, Position 1 ; Club Name 2, Position 2 ......
Your answer
Dinner Option / Preference *
Is a firm sponsoring you? *
If yes, please show your confirmation email to student.
If yes, identify which firm sponsored you.
Your answer
Would you like to volunteer? *
We appreciate all the help we can get! An email will be sent to your CSUN email with further instructions.
Please complete the captcha before submitting the form.
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