Delta Kappa Gamma Society International
Sheraton Shreveport Hotel
Name____________________________________________Chapter_______________
Mailing Address
_____________________City_______________,LA Zip
Code_____
E-Mail
Address_______________________________Phone Number______________
Please sign if you DO
NOT grant permission to publish picture of yourself:
___________________________________
District {Circle one} C NE NW S SE SW
Check any that apply to you:
____Current State Officer ____Current
State Committee ____Current Chap.
President
____First-Time Attendee ____25 Year Member ____50 Year Member
____Current
Dist. Dir. ____Past State Pres. ____55+ year member
____State Achievement Award
Winner ____Active Member
MEALS MUST BE PURCHASED IN ADVANCE. Prices
include tax and gratuity.
Registration Fee (required
for Attendance) $
5.00 ______
Presidents’ Breakfast (Current state officers, district directors, and
chapter presidents) $15.00 ______
Birthday Luncheon $20.00 ______
Founders’ and Presidents’
Banquet $25.00 ______
Sunday Brunch $12.00 ______
Total Enclosed
Diabetic/Vegetarian________________________________
(Specify)
Allergies
(Seafood, etc.)________________________________
Make checks payable to: LOUISIANA DELTA KAPPA GAMMA CONVENTION, 2004
DEADLINE:
(NO REFUNDS OR CANCELLATIONS AFTER
Mail check and registration
form to Anne Anderson
apand@aol.com
RESERVATIONS FOR ROOMS AT THE
SHERATON: 1-800-321-4182
FLAT RATE ( 1-4 PERSONS) $82.00 (Plus taxes)
Cut Off Date:
*Let Hotel know if you need a special room at reservation time
Each person/chapter is responsible for
ordering//paying but host chapter will have them delivered if you use
FLOWERS FOR YOU 318.797.7000 0r 1-800-259-7980