2011 State Leadership Conference Registration

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Zeta Phi Beta Sorority, Inc.

State of Delaware

2011 Delaware State Leadership Conference


Friday, April 8, 2011 thru Sunday, April 10, 2011

“The Image of Zeta is You”


Doubletree Hotel Downtown Wilmington
700 N. King Street, Wilmington, Delaware, 19801
Tel: 1-302-655-0400 www.doubletree1.hilton.com

Name____________________________ ___________________________________
Last First MI
Address______________________________________________________________

_____________________________________________________________________
City State Zip
Day Phone: ______________________ Cell Phone: ___________________________

Chapter: _________________________ E-mail: ______________________________

Registration Status (check all appropriate boxes)

[ ] National Appointed Officer [ ] Regional Elected Officer [ ] Regional Appointed Officer


[ ] State Elected Officer [ ] State Appointed Officer [ ] Graduate Member
[ ] Undergraduate Member [ ] Life Member [ ] Amicae
[ ] Youth Auxiliary

□Graduate Member = $125 □Graduate Member (65+) = $90 □Undergraduate Member = $75
□Amicae = $90 □Youth Auxiliary = $45
Registration includes workshops, conference materials, events and meals.
No onsite registration. Business attire is required for attendance.

Return this form with payment no later than Friday, March 25, 2011 to:
State of Delaware, 560 Peoples Plaza, #105, Newark, DE 19702
Make checks payable to: Zeta Phi Beta Sorority, Inc. – State of Delaware

FOR STATE USE ONLY


FOR REGISTRAR’S USE ONLY
Date Rec’d ______ Amount Rec’d _______ Receipt #: _______

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