2012 OAC Greek Life Leadership Conference

Saturday, November 10, 2012

Please fill out this form to account for all participants attending. The cost will be $250 per institution and $15 per participant. The check should be written to Otterbein University and mailed to:

Mike Stumpf

100 W. Home St.

Campus Center

Westerville, OH 43081

Deadline for all registrations: October 26, 2012

Conference Website

Institution: *

Contact Name: *

Please select one person from your institution to serve as a contact for matters related to your registration.

Contact Phone: *

Contact Email: *

Information will be sent to this address as a receipt of all the information entered.

Please provide information for all participants attending including any staff/advisors. These individuals will not be charged.

Participant 1

First and Last Name:

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Affiliation (no symbols or abbreviations):

Leadership Position:

Dietary Restriction:

Participant 2

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Participant 3

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Participant 4

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Participant 5

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Participant 6

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Participant 7

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Participant 8

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Participant 9

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Participant 10

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Participant 11

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Participant 12

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Participant 13

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Participant 14

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Participant 15

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Participant 16

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Participant 17

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Participant 18

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Participant 19

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Participant 20

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Participant 21

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Participant 22

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Participant 23

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Participant 24

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Participant 25

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Participant 26

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Participant 27

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Participant 28

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Participant 29

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Participant 30

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