Salu salo Registration Form v1 .pdf

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SALU-SALO SA SAN FRANCISCO 2016
Registration Form
Required Information
1.
2.
3.
4.
5.
6.
7.
8,
7.
8.
9.

Last Name
First Name
Middle Initial
USP Batch
SDP Batch
Campus – Diliman/Los Banos
Spouse/Partner Last Name
Spouse/Partner First Name
Number of Guests – Adult/Minor Children
Are you staying at Sofitel – Yes/No
Check which event you will attend
a. Kambingan
b. Plenary Session
c. Dinner/Dance
d. Picnic
10. Which chapter do you belong
11. Registration Fee
If you pay now but before December 31, 2015
a. Upsilonian/Sigma Deltan
- $269.oo each
b. Spouse/Guest - not USP or SDP - $200.oo each
If you pay on or after January 1, 2016
a. Upsilonian/Sigma Deltan
- $299.oo each
b. Spouse/Guest – not USP or SDP - $200.oo each
12. Method of Payment
a. Check - send to: __________________________
b. Bank Transfer – Wells Fargo
Account – Upsilon Sigma Phi, N.A,
Routing/Account No. – 1211042882 9056910871
c. PayPal – send via - anilommq@yahoo.com


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