UCSD Excel Leadership Conference 2009

Conference Date: Saturday February 28th, 2009
Pre-Conference Time: 9am - 12pm
Conference Time: 12:30pm - 4:30pm

Please use a separate registration form for each person.
Please indicate which payment option you will be making.

First Name:

Last Name:

E-mail:

In case of emergency please notify

Name:

Relationship:

Phone:

School Affiliation:

If your school was not on the list, please type it in here:

Organizations/Chapter Affiliation

Year in College/University?

Is this your first Excel Leadership Conference?

How did you hear about the 19th Annual Excel Leadership Conference?

If you choose "Other", please specify:

If an organization or chapter is paying for you, please list here:

PAYMENT INFORMATION

	General Conference Admission	General Conference + Pre-Conference Admission
UCSD Students	$5	$15
Non UCSD Students/Staff/Faculty	$25.00	$35.00

Payment Options (Select one):

PAYMENTS MADE BY CHECKS
- MAKE CHECKS PAYABLE (IN US FUNDS ONLY) TO: UCSD EXCEL
- MAIL OR DROP OFF TO:
     University of California, San Diego
     Center for Student Involvement
     c/o Marilyn Russell
     9500 Gilman Drive
     La Jolla, CA 92093-0078
PAYMENTS MADE BY PAYPAL
- A LINK WILL BE PROVIDED AFTER SUBMITTING THIS FORM.

CONFERENCE REFUND POLICY

All refund requests must be submitted in writing to ucsdexcel@gmail.com.
Refunds will not be granted after Feburary 25, 2009

* Day of registration attendees are welcome!