Florida District of CKI
District Convention
February 19-21, 2010 ● Double Tree, Cocoa Beach
Deadline to register is January 20, 2010.
After the deadline, Registration will increase to $45.
First Name
Last
Gender
Female
Male
Shirt Size
S
M
L
XL
XXL
XXXL
Email:
Home Phone:
Cell Phone:
CKI Club
Name:
Devry University
Eckerd College
Florida College
Florida Gulf Coast University
Florida State University
Johnson & Wales University
Manatee Community College
Saint Petersburg College
Santa Fe Community College
Southeastern University
St Matthew`s University
Stetson University
University of Central Florida
University Of Florida
University of South Florida - Sarasota
University Of South Florida - St. Pete
University Of South Florida - Tampa
University of Tampa
Kiwanis
(CKI Member & Advisors Only)
Are you an
officer?
enter title:
Are you a
Committee Chair?
enter title:
Are you a...
CKI Member
Guest
Key Club
Kiwanian
Are you...
Title?
Alumni Member
CKI Administrator
Faculty Advisor
Kiwanis Advisor
If an alumni member, please enter school
Are you a
Vegetarian?
YES
Any
food allergies?
if so, please list
Quad
(4 in room)
:
$210
Triple
(3 in room)
:
$225
Double
(2 in room)
:
$260
Single
(1 in room)
:
$400
Reg Only :
$175
REGISTRATION TYPE
Quad
Triple
Double
Single
Reg Only
$
Enter Notes or names of requested roommates
Please enter names of desired roommates.