Central State University
National Alumni Association
ANNUAL MEETING
June 8 - 10, 2017 | Louisville, KY
Central State University
National Alumni Association
ANNUAL MEETING
June 8 - 10, 2017 | Louisville, KY
REGISTRATION FORM
(Please Type or Print) Name:
q Dr. q Mr.
q Mrs. q Ms.
Street Address:
Home Phone No.: City: State: Zip Code:
( )
Cell Phone No.: ( )
Other Phone No.: ( )
Email Address:
CSU Graduate: q Y q N Year of Graduation: Membership Status: q CSU Life Membership q Regular q Affiliate q Non-Member
Alumni Chapter Affiliation
REGISTRATION OPTIONS FULL REGISTRATION INCLUDES: “Al l White” Cruise, Scholarship Luncheon, and Derby In June Party.
Does not include special events, hotel and transportation.
Registration Category: q Alumni q CSU Rep q Guest
q Full Registration: (open until June 1,2017) q$150.00
There is NO LATE OR ONSITE REGISTRATION. Individual event tickets can be purchased onsite until 12 PM, Saturday, June 10th. Onsite ticket purchases will be $5 additional per ticket for non-registered attendees.
INDIVIDUAL TICKET COSTS: (for non-registered guests) q Friday: “All White” Cruise on the Belle of Louisville $65.00 q Saturday: Scholarship Luncheon $50.00 q Saturday: Derby In June Party $50.00 q Donation
TOTAL PAYMENT:
$
DIETARY NEEDS: q Vegetarian q Chicken q Fish q Other___________________________
CONFERENCE LOCATION Louisville Marriott Downtown – 280 W. Jefferson Street, Louisville, KY 40202
Marriott is offering a special group rate for $129.00 USD per night. Discounted onsite parking for $18 per night. Free WiFi for the duration of your stay. Book your event rate for Central State at https://aws.passkey.com/e/49115569 or
call-in your reservation at 1-800-266-9432 by Friday, May 12, 2017. Click on Group Codes Enter
GROUP CODE: National Alumni Association of Central State University
Central State University
National Alumni Association
ANNUAL MEETING
June 8 - 10, 2017 | Louisville, KY
PAYM ENT INFORM ATION REGISTRATION BY MAIL: Mail completed form with payment to:
Central State University Office of Alumni Relations
PO Box 269 Wilberforce, OH 45384
Method of payment include check, money order, or you may pay online at http://centralstate.universitytickets.com.
Please make checks payable to: Central State University National Alumni Association
REGISTRATION CANCELLATION POLICY: Registration fees are not refundable.