TYPE of REGISTRATION	DEADLINE	COST
Early Registration	TO BE DETERMINED	$200
Standard Registration	TO BE DETERMINED	$210
Late Registration	TO BE DETERMINED	$225

First Name^*

Last Name^*

Escort Name

Please enter the first name and last name of your escort if they are also attending the convention.

Is Escort an Envoy?

Chapter^*

Please enter your full chapter name including the City and State.

Degree^*

Select your Beta Sigma Phi degree.

Total Years

Please enter the total number of years you have been a member of Beta Sigma Phi.

Address

Address Line 1 ^*

Address Line 2

City ^*

State or Region ^*

Zip ^*

Email^*

Phone Number

Please enter your phone number.

Dietary Restrictions

Vegan
Diabetic

Please select any dietary restrictions you may have.

Other Restrictions

If you have any other restrictions that you may need assistance with, please let us know here.

Choice of Entree for the Saturday Night Dinner (choose one entree per person on your registration form)

Use the other box to specify if both people want the same meal choice.

Dinner Options

Roast Tenderloin of Beef with Port Wine Glaze served on a Gorgonzola and Sourdough Crouton
Chicken Saltimbocca: Sauteed Chicken Breast with Mushrooms, Sage, Prosciutto Ham and Topped with Mozzarella Cheese
Grilled Salmon Fillet Topped with Tomato Basil Provencal and Sauteed Rock Shrimp
Vegetarian Option
Other

Please select your meal choice for Saturday night. If you and your escort want the same meal, please indicate that in the additional field.

Registration^*

Credit Card Fee^*

This charge covers the cost of credit card processing.

Other Options

Escort ($ 75)
Studio Store Table ($ 20)

On the next page you will be prompted to enter your credit card information. We are using stripe.com as our credit card processor. Stripe has all the latest security for processing your credit card securely. They are used by major companies such as Under Armor, Blue Apron, Lyft, and Doordash.

REGISTRATION

Use the other box to specify if both people want the same meal choice.