Registration Form A discounted $40 Homecoming package, which includes all regular events on campus, is available until Aug. 31. After Aug. 31, the package price is $50. Children under 10 years of age are free.
How to register: There are several ways to register. Choose the one that works best for you. If you choose to mail, fax, or e-mail, please complete the form below and return as indicated.
send by mail: Indiana Tech Alumni Office 1600 E. Washington Blvd. Fort Wayne, IN 46803 send by fax: 260-420-1453
register by phone: 800.937.2448 ext.2219 register online: www.IndianaTech.edu/homecoming e-mail your registration: REReplogle@IndianaTech.edu
Participant Information First Name______________________________________ Middle Initial___________ Last Name_________________________________________________ Maiden Name__________________________________________________________ Spouse/Guest Name_________________________________________ Street Address___________________________________________________________________________________________________________________ City__________________________________________________________________ State________________________________ Zip Code______________ E-mail__________________________________________________________________________________________________________________________ Home Phone________________________________ Cell Phone________________________________ Work Phone _________________________________ Graduation Year(s)________________________ Degree(s)________________________________________________________________________________
Event Registration
# of packages
□ Homecoming Package—all events ($40/person)................ ______ (increases to $50 after Aug. 31, 2012) Package does NOT include the TWIST XXIII Golf Outing or the ‘Dancing to the Decades Party, however the Dancing Party is free with Tech student, staff or faculty ID or Alumni Association Membership card.
For the following, please check each event you plan to attend, whether purchasing the package or not. Please also fill in the total number of attendees, including yourself, in the column on the right.
Payment
Thursday, September 13
# of attendees
Friday, September 14
# of attendees
□ President’s Club Dinner (By invitation only).......................................................... ______ □ 50-Year Reunion Luncheon...................................................................................... ______ ($10/person without Homecoming Package)
□ TECHnology 101.......................................................................................................... ______ □ Guided Campus Tours............................................................................................... ______ □ Dancing to the Decades Party.................................................................................. ______
(Free with Tech student, staff or faculty ID; Alumni Association card; otherwise $10/person)
Saturday, September 15
# of attendees
□ Prayer Service............................................................................................................ ______ □ Breakfast with the President.................................................................................... ______ ($10/person without Homecoming Package) □ Alumni Association Annual Meeting....................................................................... ______ □ Road Warrior Cruise-In featuring Live Music from Unfinished Business ............. ______ □ Lunch in Andorfer Commons................................................................................... ______ □ Scholarship Luncheon (invitation only).................................................................. ______ □ Alumni Men’s Baseball Game................................................................................... ______ □ Wine Reception – Hosted by the Indiana Tech Alumni Board.............................. ______ □ Alumni Banquet & Awards Ceremony..................................................................... ______ ($35/person without Homecoming Package) □ Movie & More on the Lawn....................................................................................... ______
Sunday, September 16
Please total your registration fee(s) for the events in which you will participate and complete the information below:
□ Check payable to Indiana Tech Credit Card: □ MasterCard □ Visa □ Discover □ American Express Card Number:_____________________________________________ Card Validation Number:____________________________________ (Three-digit number on the back of your credit card or four-digit number on the front of the American Express Card.) Expiration Date:___________________________________________ Name As It Appears On Card:_______________________________ Authorization: I hereby certify that I am the above credit card owner and authorize Indiana Tech to charge my card in the amount of $______ Signature:________________________________________________
Thank you for planning to join us for this exciting weekend. We look forward to seeing you on campus in September!
# of attendees
□ TWIST XXIII Golf Outing............................................................................................. ______ (Entry Fee is $80/person, $25/Indiana Tech student, $320/foursome)
Cut along dotted line or photocopy and return this form to the Alumni office. You can also fax, call, or e-mail us with your registration information.