SLC Registration Summary Form
DEADLINE: February 12 at 11:59 p.m.
Chapter
*
Email of Adviser completing this form
*
(Needed for receiving auto-generated confirmation of entry.)
Adviser(s) attending SLC
Adviser 1
*
First Name
Last Name
Adviser 2
First Name
Last Name
Adviser 3
First Name
Last Name
Student Teacher(s) attending SLC
Student Teacher 1
First Name
Last Name
Student Teacher 2
First Name
Last Name
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Conference Registration
Fee includes one (1) Meal on Friday evening.
Members - $71 each
*
Enter number of members attending (do not include your state officer here)
Member total
State Officer(s) - Fee Waived
*
Adviser(s) - $71 each
*
Adviser total
Chaperones + Student Teacher(s) - $45 each
*
ENTER 0 IF NOT APPLICABLE.
Chaperone/Student Teacher total
Total Attending SLC
Registration Fee Subtotal [4200-03]
Scholarship Fund and Star Volunteer Award
**If participating in either or both, please upload or indicate completion of the appropriate required form.
Scholarship Fund Total [4820-03]
*
1) IF NOT APPLICABLE, ENTER 0. 2) INCLUDE THE AWARD FEE IN YOUR REGISTRATION CHECK. (minimum $50 donation)
Upload completed Scholarship Fund Form
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Required to receive special recognition for donation.
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Online Star Volunteer Award form submitted
# of Star Volunteer Awards
*
1) IF NOT APPLICABLE, ENTER 0. 2) SUBMIT ONLY IF A CHAPTER HAS A NOMINEE. 3) COMPLETE THE ONLINE NOMINATION FORM. 4) INCLUDE THE AWARD FEE IN YOUR REGISTRATION CHECK.
Star Volunteer Amount Due [4250-03]
# of Businessperson Awards
*
1) IF NOT APPLICABLE, ENTER 0. 2) SUBMIT ONLY IF A CHAPTER HAS A NOMINEE. 3) COMPLETE THE ONLINE NOMINATION FORM. 4) INCLUDE THE AWARD FEE IN YOUR REGISTRATION CHECK.
Online Businessperson of the Year Award form submitted.
Businessperson Award Amount Due [4250-03]
Scholarship Fund, Star Volunteer, and Businessperson Award total amount due
TOTAL SLC REGISTRATION DUE
Please let Jessica or Jacqui know if calculations on this form do not match yours.
Total Amount Due:
Make check payable to Nebraska FBLA. Mail check with the confirmation email to Grafton & Associates, P.C. , 5935 S. 56th St STE A
Chapter Permission Form - Please upload as PDF
*
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of
Blue Panda Registration Confirmation - Please upload PDF
*
Browse Files
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of
Submit
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