80th Tenth District Convention

PLEASE ENTER INFORMATION (A separate form must be submitted for each attending Brother)
Enter your First Name. Please use proper spelling with the first letter capitalized.
Enter your Last Name. Please use proper spelling with the first letter capitalized.
Enter your personal email address. If you are assisting another brother, please your chapter KRS email address.
Please enter your phone number - preferably your cell phone.
Enter your Control Number with two leading zeros. Ex. 009999999
Please select your correct chapter. If you chapter does not exist, please select "Other" and enter the chapter name ONLY. DO NOT add Chapter at the end NOR any chapter nicknames. (Ex. Omicron Theta)
OMEGA PSI PHI FRATERNITY, INC.
80th TENTH DISTRICT CONVENTION
Hosted by: Chi Lambda Lambda Chapter
Holiday Inn - Matteson
500 Holiday Plaza Dr
Matteson, IL 60443
April 6-9, 2017
Please enter the city where your chapter resides - Ex. Chicago. Please use proper spelling with the first letter capitalized.
Please select the state where your chapter currently resides.
Enter your full home address.
Enter your home address - Ex. 123 S. Buck Rd.
Enter your home city - Ex. Chicago. Please use proper spelling with the first letter capitalized.
Selected your home state
Enter your home zip code - Ex. 60606. Please use 5 digits.
Brothers are expected to select one status for this meeting
** Select your classification in order to see the appropriate regsitration fees. **
PLEASE MAKE SURE YOU SELECT THE CORRECT AMOUNT BASED ON WHEN YOU REGISTER.
PLEASE MAKE SURE YOU SELECT THE CORRECT AMOUNT BASED ON WHEN YOU REGISTER.
Online Payment Option:
Brothers wishing to use this option must submit this form and then: Copy or Click this link - https://squareup.com/store/tenthd-sales/
MAKE CHECKS PAYABLE TO:
10th District Meetings

PRINT and MAIL COMPLETED FORMS & CHECKS TO:
Bro. Derrick Ivory
Attn: Tenth District Convention
708 Chateau Valley Ct
Ferguson, MO 63135

CONTACT INFO:
District Marshal, Byron Williams at 312-576-6017

HOUSING - HOST HOTEL:

Holiday Inn - Matteson
500 Holiday Plaza Dr
Matteson, IL 60443
Tel: +1-708-747-3500

Discount Rate $99 Use Code: OPP, which good only for 4/6 - 4/9/2017

Online Hotel Registration: CLICK HERE - Hotel Registration

Sending