Home

Vitae

Mu Beta Committee Appointment

Register for the Gottman Level I Training

Register for the Gottman Level II Training

Register for 2017 Mu Beta Induction Ceremony

Register for 2017 Dr. Granello Suicide Training Workshop

Donec eu mi .

E-Mail: sburns1@kent.edu

Mu Beta Logo

Mu Beta Chapter of Chi Sigma Iota Induction Ceremony Registration Form (Step 1 of 2 Steps)

On this first page you will fill out the registration form and on the second page you will pay for the ceremony.

Please view the 2017 Mu Beta Induction Flyer for complete details. Click here for a map to the location.

Select your primary role:


First Name
Last Name
Home Street Address
City
State
Zip
Home Phone
Work Phone
E-mail (*Required. A confirmation e-mail will be sent immediately after submitting the registration form today.
Verify your e-mail address (*Required. A correct and valid e-mail address is essential to processing your registration on-line.)

Including yourself, how many ceremony registrations are you paying for today?


Including yourself, please list the name(s) of those you are are paying for today. This information will be used for registration check-in.
First person - First Name Last Name
Second person - First Name Last Name
Third person - First Name Last Name
Fourth person - First Name Last Name
Fifth person - First Name Last Name
Sixth person - First Name Last Name
Seventh person - First Name Last Name
Eighth person - First Name Last Name
Ninth person - First Name Last Name
Tenth person - First Name Last Name

Enter the security code you see in the box with blue letters to the left:

Once submitted, you will receive an e-mail copy of your registration form and taken to the page where you will pay for the ceremony.