$25.00 registration fee per personSchool:Choose school... Blue Ridge Community & Technical College - Martinsburg Blue Ridge Community College - Weyers Cave Campus Central Virginia Community College - Lynchburg Dabney S. Lancaster Community College - Clifton Forge Danville Community College - Danville Eastern Shore Community College - Melfa Eastern West Virginia Comm & Tech Colleg - Moorefield ECPI College of Technology - Newport News Campus ECPI College of Technology - Northern Virginia Campus ECPI College of Technology - Virgina Beach Campus Germanna Community College - Locust Grove J. Sargeant Reynolds Community College - Downtown Campus J. Sargeant Reynolds Community College - Parham Campus John Tyler Community College - Chester Campus John Tyler Community College - Midlothian Campus Lord Fairfax Community College - Fauquier Campus Lord Fairfax Community College - Middletown Campus Marshall Comm-Tech College - Huntington Mountain Empire Community College - Big Stone Gap New River Community & Tech. College - Lewisburg Campus New River Community College - Dublin Northern Virginia Community College - Alexandria Campus Northern Virginia Community College - Annandale Campus Northern Virginia Community College - Loudoun Campus Northern Virginia Community College - Manassas Campus Northern Virginia Community College - Medical Education Campus Northern Virginia Community College - Woodbridge Campus Northern Virginia Community College - Woodbridge Campus Patrick Henry Community College - Martinville Paul D. Camp Community College - Franklin Piedmont Virginia Community College - Charlottesville Pierpont Community and Technical College - Fairmont Rappahannock Community College - Warsaw Campus Richard Bland College - Petersburg Southern WV Community & Tech. College - Williamson Campus Southside Virginia Community College - Alberta Campus Southside Virginia Community College - John H. Daniels Campus Southwest Virginia Community College - Richlands Thomas Nelson Community College - Hampton Tidewater Community College - Chesapeake Campus Tidewater Community College - Portsmouth Campus Tidewater Community College - Thomas W. Moss Campus Tidewater Community College - Virginia Beach Campus Virginia Highlands Community College - Abingdon Virginia Western Community College - Roanoke West Virginia State Comm & Tech College - Institute West Virginia Univ. Inst. of Technology - Montgomery West Virginia University at Parkersburg - Parkersburg Campus Wytheville Community College - Wytheville Other: Advisor: Advisor Phone: President: President Phone: Contact email: Please enter all registrants below: Check the "veg" box if the registrant prefers a vegetarian meal First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship First: Last: Advisor Member Check Scholarship Mail payment to: Michael Brown PO Box SVCC, Southwest Virginia Community College Richlands,VA 24641 Please make checks Payable to: Phi Theta Kappa of Virginia EIN #91-1777-607 Deadline for registration is: September 11 Please note: The number of people registered as of September 11, is the number of registrations that the chapter must pay for. Additional registrations may be added after September 11, depending on space available. Refund Policy: No refunds for cancellations after September 11 Receipts: If a receipt is requested, a self-addressed envelope must be included with the payment.
School:Choose school... Blue Ridge Community & Technical College - Martinsburg Blue Ridge Community College - Weyers Cave Campus Central Virginia Community College - Lynchburg Dabney S. Lancaster Community College - Clifton Forge Danville Community College - Danville Eastern Shore Community College - Melfa Eastern West Virginia Comm & Tech Colleg - Moorefield ECPI College of Technology - Newport News Campus ECPI College of Technology - Northern Virginia Campus ECPI College of Technology - Virgina Beach Campus Germanna Community College - Locust Grove J. Sargeant Reynolds Community College - Downtown Campus J. Sargeant Reynolds Community College - Parham Campus John Tyler Community College - Chester Campus John Tyler Community College - Midlothian Campus Lord Fairfax Community College - Fauquier Campus Lord Fairfax Community College - Middletown Campus Marshall Comm-Tech College - Huntington Mountain Empire Community College - Big Stone Gap New River Community & Tech. College - Lewisburg Campus New River Community College - Dublin Northern Virginia Community College - Alexandria Campus Northern Virginia Community College - Annandale Campus Northern Virginia Community College - Loudoun Campus Northern Virginia Community College - Manassas Campus Northern Virginia Community College - Medical Education Campus Northern Virginia Community College - Woodbridge Campus Northern Virginia Community College - Woodbridge Campus Patrick Henry Community College - Martinville Paul D. Camp Community College - Franklin Piedmont Virginia Community College - Charlottesville Pierpont Community and Technical College - Fairmont Rappahannock Community College - Warsaw Campus Richard Bland College - Petersburg Southern WV Community & Tech. College - Williamson Campus Southside Virginia Community College - Alberta Campus Southside Virginia Community College - John H. Daniels Campus Southwest Virginia Community College - Richlands Thomas Nelson Community College - Hampton Tidewater Community College - Chesapeake Campus Tidewater Community College - Portsmouth Campus Tidewater Community College - Thomas W. Moss Campus Tidewater Community College - Virginia Beach Campus Virginia Highlands Community College - Abingdon Virginia Western Community College - Roanoke West Virginia State Comm & Tech College - Institute West Virginia Univ. Inst. of Technology - Montgomery West Virginia University at Parkersburg - Parkersburg Campus Wytheville Community College - Wytheville