Convocation Weekend 2013 Registration Form
Convocation will be held Saturday, July 20, 2013 at Wait Chapel beginning at 10:00 am.
The luncheon will be held at Old Town Club at 11:30 am.

Old Town Club
2875 Old Town Club Road
Winston-Salem, NC

Registration Deadline: July 13, 2013

(No refunds will be issued after this date.)

Please complete the following information. Required fields are marked with an asterisk (*).
Registrant Information
Please enter your phone number in the following format: xxx-xxx-xxxx.
Saturday, July 20
(Include total number of persons attending, including student, if applicable)
 @  $25.00
 @  $10.00

Please list the names of all guests, separated by a comma.

Payment Information
Please check your information carefully for accuracy, and then click "Submit."