Black Male Development Symposium 2010

 
Registration for Groups

Event Date: Saturday, May 15, 2010

Location: Arcadia University, Glenside, PA

Registration Costs: Middle/High School Students/College Students: $25; Adults/Group Leaders: $45

Deadline: Monday, May 3, 2010

Payment: Online registrants will receive e-mail confirmation. Please print out confirmation and mail with total payment due to: Arcadia University, Attention: Judy Dalton, 450 S. Easton Road, Glenside, PA 19038. Make checks payable to Arcadia University/BMDS.

Questions? Contact Judy Dalton at 215-572-8510 or bmds@arcadia.edu.

 Salutation:  

 
*
Contact Name:  

*Organization:  

*Address:  

*City:   State:   Zip:  

*Phone:  

Alternate Phone:  

Fax:  

*E-mail:  

Please check if you are applying for:  

 
Name of on-site person at event:  

Number of Students attending: 

 x $25/each = Total Due for Students $  

 
Number of Adults/Group Leaders attending:

 x $45/each = Total Due for Adults/Leaders $  

 
Total Payment Due: $  

I understand that I must print out e-mail confirmation and mail with total payment due to: Arcadia University, Attention: Judy Dalton, 450 S. Easton Road, Glenside, PA 19038. Make checks payable to Arcadia University/BMDS.