2019 Convention Registration

First Name:*
Last Name*
Are you an AIDB staff member?*
Address:*
City:*
State:*
Zip Code:*
E-mail:*
Will you have any guests?*
Guest Names:*


ROOM INFORMATION

Will you be staying on campus? *
How many rooms will you need?*

WOMEN - WARD 1 & WARD 2
MEN - WILLIAMS 1 & WILLIAMS 2
COUPLES - MONROE & ORR

Room Request:*


COMMUNICATION PREFERENCES

Letters:*
BRASS:*
Directory:*


TICKETS & COST

Membership Dues: ($10 Each)*
Registration: ($20 Each)*
Breakfast: ($5 Each)*
Banquet: ($10 Each)*
Chill Out & Grill Out Lunch: ($8 Each) Sno Biz sold separately*
Transportation: ($25 Round Trip fare) (Birmingham Only)*
Talent Show DVD: ($5 Each)*


DONATIONS

BRASS Donation:
 $ 
Alumni Scholarship Fund:
 $ 
Don Sims Student Activity Fund:
 $ 
Total Amount Due: