EVENT REGISTRATION
Delegate/Alternate or Guest Registration
PLEASE USE ONE FORM PER PERSON
Name __________________________________________________ Chapter No. ______________ District No. ______________
Address ___________________________________________________________________________________________________
City ____________________________________________________ State __________________ Zip Code __________________
Phone (____) _________________________ Fax (____) __________________________ Email __________________________
For Which Organization Events Are You Registering? Please check one on each line.
AHEPA
Daughters of Penelope
I Am Registering :
Fees
Delegate
Alternate
Membership No. ______________________________
Guest (accompanying) ________________________________________________
*AHEPA FAMILY DELEGATES/ALTERNATES/GUESTS NOT STAYING
AT THE CONVENTION HOTEL MUST PAY THE $350 REGISTRATION FEE
AHEPA Delegate/Alternate
$350 ($250 if purchased by June 5) $ ______________
(Includes: Opening/Welcome Night, Golden Gate Cruise, Greek Night,
Athletic Luncheon and Grand Banquet)
DOP Delegate/Alternate
$350 ($250 if purchased by June 5) $ ______________
(Includes: Opening/Welcome Night, Golden Gate Cruise, Greek Night,
Athletic Luncheon and Grand Banquet)
Non-Delegate/Guest
$375
$ ______________
(Includes: Opening/Welcome Night, Golden Gate Cruise, Greek Night,
Athletic Luncheon and Grand Banquet)
Checks payable to:
AHEPA Supreme Convention
Fees MUST accompany this form
Mail to:
AHEPA
1909 Q Street, NW Suite 500
Washington, DC 20009
TOTAL
$ ______________
I have enclosed Check No. ____________ in the amount of $ ____________
Charge my:
VISA
Master Card
AMEX
Card No. _____________________________________ Exp. Date ____________
Signature _________________________________________________________
Deadline
Form and fees MUST be postmarked, faxed, or emailed
by Friday, June 5, 2015
Refund Policy
Refund requests MUST be received in writing by Friday, June 5, 2015.
If received by this date, a refund will be issued, less a $35 administrative fee.
No refunds will be issued after June 12, 2015!
www.ahepa.org