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DELTA OMICRON

INTERNATIONAL MUSIC FRATERNITY

 

CONFERENCE COLLEGIATE DELEGATE AND ALTERNATE

 

Send this form to the Executive Secretary and a copy to the Province President after the chapter’s delegate and alternate are selected. The form should be postmarked no later than April 1 in the year of the Triennial Conference. If the delegate’s registration fee has not yet been paid, a check in the amount of the registration fee should accompany this form mailed to the Executive Secretary.

 

Chapter   __________________________                                  Province   _______________________

 

Name of Conference Delegate   _________________________________________________________

(not a graduating senior)

 

School Address   _____________________________________________________________________

 

School Phone   _______________________________________________________________________

 

E-Mail Address   _____________________________________________________________________

 

Summer Address   ____________________________________________________________________

 

Summer Phone   __________________________________

 

 

 

Name of Conference Delegate Alternate   _________________________________________________

(will attend if delegate cannot)

 

School Address   _____________________________________________________________________

 

School Phone   _______________________________________________________________________

 

E-Mail Address   _____________________________________________________________________

 

Summer Address   ____________________________________________________________________

 

Summer Phone   __________________________________