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PSE Fall Regional Conference Registration

Please complete the following form to register for the following regional conferences: Western, North East, Atlantic and Midwest. Click on the button for your regional to see a schedule of events.

If you are having problems registering, please call the PSE Headquarters office, 800-761-9350.

REGISTRATION INFORMATION*

First Name:

Last Name:

School:

Company:

Address:

City:

State:

Zip:

Phone:

Email:

REGISTRATION FEE:

	Oct. 12-14, 2007 - Southern Regional Conference - Baton Rouge, LA - $45 Registration Fee
	Oct. 19-21, 2007 - Atlantic Regional Conference - Greensboro, NC - $60 Registration Fee
	Oct. 26-28, 2007 - North Central Regional Conference - Toledo, OH - $45 Registration Fee
	Nov. 2-4, 2007 - Midwest Regional Conference - Carbondale, IL - $50 Registration Fee
	Nov. 9-11, 2007 - Western Regional Conference - San Diego, CA - $68 Registration Fee
	Nov. 16-18, 2007 - North East Regional Conference - Hartford, CT - $66 Registration Fee

Requests for refunds must be in writing and are subject to a $10 cancellation fee.
No refunds given if cancellation is given with in 72 hours. At that time meal counts have already been given and that is what registration fee pays.

SPECIAL REQUESTS:

Vegetarian Meals:

Yes No

I would like to compete in the Pro-Am Sell-A-Thon

You do need to register online to participate

Yes, I would like to compete in the National Speakers Competition

Title of Speech

I am planning to attend the Certified Chapter Officer Program

Position to be trained

PAYMENT INFORMATION:*

Payment will be mailed with
Chapter Check

Name on Card

Credit Card:

Visa Mastercard American Express

Credit Card Number:

Card Expiration:

Billing Address:

City:

State:

Zip:

Billing Phone:

You will have one final chance to review your order before submitting.

Pi Sigma Epsilon, 3747 S. Howell Ave. Milwaukee, WI 53207
Phone: (414) 328-1952, Toll-Free: (800) 761-9350, Fax: (414) 328-1953, E-mail: pse@pse.org