Georgia 4-H
Georgia 4-H Event Registration
 
09/28/2017 -- Volunteer Conference of Southern States

Instructions --

  1. Fill out this form, select payment method, and click the "Continue" button at the bottom of the page.
  2. If you choose to pay by Mail, you will be asked to print and mail the next page.
  3. If you choose to pay by Credit Card. You can verify that the information is correct and then click"Pay Now" on the next page.
  4. Your registration will not be recorded until the payment has been succefully processed.

The registration deadline of 09/15/2017 08:00AM has passed.
No more records can be inserted.
Please contact the event manager.

Select
County of Residence
or 'Not GA Resident'
     
Last Name: First Name:
Address:
City:
State:
Zip:
       
email:
gender:  
 
Select Options
Full Time Conference Registration $295.00   
Part Time Registration Options
Thursday only Registration $50.00   
Thursday lodging (includes (Friday breakfast) $50.00   
Friday only Registration (includes lunch & dinner) $100.00   
Friday lodging (includes Saturday breakfast) $50.00   
Saturday only Registration (includes lunch & dinner) $100.00   
Saturday Lodging (including Sun Breakfast) $50.00   
Late Fee (added after August 25) $50.00  After 08/25/2017 11:59PM 
Workshop Presenter or Volunteer Discount
Discount for Presenter or Volunteer ($30.00)   
Other Information
State - Territory Representing
Ethnic Group
T-Shirt Size
Thursday Evening Activity
Xtreme Campout - Friday Night (you must provide your own tent and sleeping bag)
Dietary Needs (vegan, peanut free, gluten free, other)
Roommate Request
Emergency Contact Information
Name
Phone Number
Relationship
Payment Information: If not paying by Credit Card, please indicate how your payment is being made: Personal Check (postmarked before September 14) OR Purchase Order through the University (Approval will be confirmed through your state’s volunteer specialist. Should you not be approved payment is expected before Sept 14 or a late fee will be added)
Personal Check or Purchase Order
The closing date of 09/15/2017 08:00AM has passed. No more participants can be entered.
© 2006 - 2013 Georgia 4-H -- Georgia4H.org
The University of Georgia and Ft. Valley State University, the U.S. Department of Agriculture and counties of the state cooperating. The Cooperative Extension Service offers educational programs, assistance and materials to all people without regard to race, color, national origin, age, sex or disability. An equal opportunity/affirmative action organization committed to a diverse work force.