PHI BETA SIGMA FRATERNITY INCORPORATED
36th Annual Gulf Coast Regional Conference - April 1-3, 2010
“Changing Lives Through Service”

Hilton Arlington
2401 East Lamar Boulevard
Arlington, TX. 76006
817-640-3322, Ext-6606

(Hotel Rate - $99.00 per night) – Cut off date is March 1, 2010

REGISTRATION FORM


Please email webmaster@gulfcoastsigma.com if you have any questions about the online registration process.

First Name: Last Name:
National/Region/State Office: None National Regional State
Chapter:
Life Member: Yes No
First Time Attendee: Yes No
Address Line 1:
Address Line 2:
City: , State: AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AA AE AP AS FM GU MH MP PR PW VI Zip:
Email:
Phone: - -
Registration Fees: Includes, but not limited to, admission to hospitality, continental breakfast, DSC Luncheon, workshops, exhibits, and meetings.

Select the Committee you wish to be a participating member of. Committee assignments will be completed on March 22, 2010. Committee meetings are scheduled for Thursday, April 1, 2010 from 8:00 pm until 10:00 pm.
Committees: Chapter Reports Collegiate Affairs Grievance Nominations Resolutions Chapter Display Historical Archives Necrology and Rededication Audit Time and Place Credentials Awards Laws and Revision

Please note deadlines below:

Affiliation:	Early Bird Ends 1/31/10	Pre-Registration 2/1/10 - 3/21/10	On-site Registration after 3/15/10
Collegiate	$80	$100	$110
Alumni	$100	$120	$145
Guest (includes DSC Luncheon and Shuttle Tour to Shopping Area)		$30	$40

Refunds: Written requests for refunds shall be postmarked no later than March 19, 2010. Send refund request to address below.
Phi Beta Sigma Fraternity, Inc.
Gulf Coast Region
P. O. Box 411340
Dallas, TX 75241