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SC State Convention Registration
Convention Home
Printable Registration Form
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Area 62 Committees
Registration is $40 per member. Complete the form below for up to 4 members then click the submit button to send registration payment.
Number of Attendees:
0
1
2
3
4
Attendee #1
Name:
Street Address:
City:
State:
Zip Code:
Phone:
Email Address:
Badge Information
Badge Name:
City or Group Name:
Special Needs/Accessibilty
Please list any Special Needs or Accessibility Issues:
Attendee #2
Name:
Street Address:
City:
State:
Zip Code:
Phone:
Email Address:
Badge Information
Badge Name:
City or Group Name:
Special Needs/Accessibilty
Please list any Special Needs or Accessibility Issues:
Attendee #3
Name:
Street Address:
City:
State:
Zip Code:
Phone:
Email Address:
Badge Information
Badge Name:
City or Group Name:
Special Needs/Accessibilty
Please list any Special Needs or Accessibility Issues:
Attendee #4
Name:
Street Address:
City:
State:
Zip Code:
Phone:
Email Address:
Badge Information
Badge Name:
City or Group Name:
Special Needs/Accessibilty
Please list any Special Needs or Accessibility Issues:
Total Registration: $
Scholarship Donations
Enclosed is $
for scholarships.
Donor's Name:
Total Scholarship Amount: $
I would like to volunteer
Total Payment: $
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Payment Information
Total payment due: $
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