New Student Picnic Registration
Yes, I will be attending on June 12, 2008!
From 6:00-7:30 pm
You must be a deposited student to register.
Please complete the requested information below.
Fields with a red
*
are required.
Personal Information
*
First Name:
*
Last Name:
*
Name Tag:
(your first name as it should appear)
Contact Information
*
Address:
*
City:
*
State:
*
Zip:
*
Home Phone:
(with area code, without punctuation)
Cell Phone:
(with area code, without punctuation)
*
E-Mail:
Guest Information
I am bringing
0
1
2
guests.
Name (first/last):
Name (first/last):
