registrationform by HC13011614146

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									2013
                       Beta Kappa
                        th
                       60 Anniversary
Austin, Texas
60 YEARS OF TIMELESS SERVICE
TO CAPTURE A VISION FAIR LUNCHEON


                          Name:                                        Chapter:
 Soror Registration




                          Address:                                     City:
                          State:                                       Zip:
                          Home:                         Cell:                    Email:
                          Chapter of Initiation:                       Date of Initiation:


                       Undergraduate Member -$25

                       Graduate Member- $70

                      Payment Method:
                      Check or Money Order made payable to: BETA KAPPA
                      Reference “60th Anniversary” on the memo line

                      Please mail completed registration form with payment to:
                        Beta Kappa Chapter
                        Attn: 60th Anniversary
                        900 Chicon St. Box 160
                        Austin, Texas 78702


                       Direct questions to: betakappa1953@gmail.com or
                        Soror Ryan Semien, Chairman (409)291-6217
                        Soror RoShana Adamson, Graduate Advisor (512)797-3670




                      Committee use only

                      Check #________________   Date Received:_____/______/______ Received By:__________________________

								
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