DRAFT 70th SW Regional Conference Registration Packet
Sigma Gamma Rho Sorority, Incorporated 74th Central Regional Conference Souvenir Journal Advertising Contract March 27-30, 2014 | Chicago, IL
Please check your selection. Inside Back Cover $250 (8.5 x 11) Back Cover $250 (8.5 x 11) Full Page $125 (8.5x11) Half Page $75 (8.5x5.5) Quarter Page $50 (4.5x5.5) Eighth Page $25 (4.5x2.75)
Sigma Gamma Rho - Theta Chi Sigma SEND PAYMENT WITH AD TO: Sigma Gamma Rho Sorority, Inc. Theta Chi Sigma Chapter P. O. Box 8039, Chicago, IL 60680 ATTN: Souvenir Journal
Attach a camera-ready copy of Ad with the advertising contract. The deadline for submission of material is February 21, 2014. I/ We hereby agree to purchase a _________________ page Ad for the total cost of __________________________.
Chapter / Company Name _______________________________________________________________________________ Name ________________________________________________________________________________________________ Last First Middle Address ______________________________________________________________________________________________ City __________________________________ State ________________________
Zip ___________________________
Daytime Phone Number ____________________________ Email _______________________________________________
Pay by Credit Card: Credit Card Authorization Name As It Appears On Card __________________________________________________________________________ Address ___________________________________________________________________________________________ Phone Number_______________________________________ I authorize use of my credit card for Sigma Gamma Rho - Central Region Conference Souvenir Journal Ad. _____Visa
_____Mastercard
_____Discover
Card Number ___________________________________________________ *V-Code ____________________________
_____Diner’s Club Expiration Number _________________
Total Amount of Charge(s)_________________________________
Total Authorized (including $5 handling fee) _____________________________________________________________ Signature __________________________________________________________________________________________ t.
Please check your selection. Inside Back Cover $250 (8.5 x 11) Back Cover $250 (8.5 x 11) Full Page $125 (8.5x11) Half Page $75 (8.5x5.5) Quarter Page $50 (4.5x5.5) Eighth Page $25 (4.5x2.75)
Sigma Gamma Rho - Theta Chi Sigma SEND PAYMENT WITH AD TO: Sigma Gamma Rho Sorority, Inc. Theta Chi Sigma Chapter P. O. Box 8039, Chicago, IL 60680 ATTN: Souvenir Journal
Attach a camera-ready copy of Ad with the advertising contract. The deadline for submission of material is February 21, 2014. I/ We hereby agree to purchase a _________________ page Ad for the total cost of __________________________.
Chapter / Company Name _______________________________________________________________________________ Name ________________________________________________________________________________________________ Last First Middle Address ______________________________________________________________________________________________ City __________________________________ State ________________________
Zip ___________________________
Daytime Phone Number ____________________________ Email _______________________________________________
Pay by Credit Card: Credit Card Authorization Name As It Appears On Card __________________________________________________________________________ Address ___________________________________________________________________________________________ Phone Number_______________________________________ I authorize use of my credit card for Sigma Gamma Rho - Central Region Conference Souvenir Journal Ad. _____Visa
_____Mastercard
_____Discover
Card Number ___________________________________________________ *V-Code ____________________________
_____Diner’s Club Expiration Number _________________
Total Amount of Charge(s)_________________________________
Total Authorized (including $5 handling fee) _____________________________________________________________ Signature __________________________________________________________________________________________ t.
