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Convention Registration Form
Name
*
First
Last
Address
*
City
*
State
*
Zip
*
Home or Cell Phone
*
Office Phone
*
Email
*
First Time Attending Convention
*
No
Yes
Visitor & Guest Fees
Members
Select a Local Organization
*
Chattanooga Business Women
Columbia BPW
Cumberland County BPW
Elizabethton BPW
Hardeman County BPW
Jackson Area BPW
LaFollette BPW
Lawrence County BPW
Memphis Area BPW
Music City Nashville
Paris BPW
Rockwood BPW
Rogersville BPW
At Large
I am registering as (please choose one)
Category
*
State Officer
Regional Director
Standing Committee Chair
Local President (2016-2017)
Local President's Representative
Governance Chair
Past State President
Local Delegate [MOL or SOL]
Local Member (1 Day)
Parliamentarian
Sub/Special Committe Chair
Member-at-Large
Member-at-Large (1 Day)
Young Careerist-ALT
Choose One
*
Visitor (non-member)
Guest
**One-Day registrants or Visitors pass are not eligible to
VOTE
in elections or business meetings and will
NOT
receive any materials
Functions I want to attend:
*
Visitors Pass (Friday & Saturday) $10.00
One Day Registration $20.00
Select all that apply
Member Fees
Functions I want to attend:
*
Registration Fee $45.00
Friday Lunch $35.00
Saturday Lunch & Installation $35.00
Click here to complete and submit your registration...
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