2018 Registration Form

Early Registration Fee $140 (includes lunch for two days and a banquet ticket) Late Registration fee $155 if not received by April 15, 2018 (Note: Please include the $5.00 convenience fee when paying via PayPal).

Last and First Name:*

Title*

Address:*

Phone:*

Session*

Lodge or Chapter*

Designations*

Office/Position*

Banquet Meal Option*

Extra Banquet Ticket ($65) ea.

Extra lunch ticket(s) ($30 ea.)

Email Address*

Remarks:

Send electronic payments via PayPal to: rwgsec.phaofhawaii@gmail.com (Note: Please include the $5.00 convenience fee when paying via PayPal).