BLACKtie Alumni Weekend Registration Form

Confirmation Number

Name* This field is required.

First Name

Last Name

Email* This field is required.

example@example.com

Phone Number* This field is required.

Area Code

Phone Number

Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Married or Have a Significant Other?* This field is required.

Yes

Did Your Spouse or Significant Other Attend WSU?* This field is required.

Yes

Are they joining you for BLACKtie 2018?* This field is required.

Yes

Would you like to register your spouse or significant other so that they may receive their own t-shirt, gift bag, and other items included in the registration? They do not have to be a WSU alumni to register. (A separate fee applies.)* This field is required.

Yes

Your Spouse or Significant Other's Name* This field is required.

First Name

Last Name

Do You Have Children?* This field is required.

Yes

Number of Children* This field is required.

1-2

3-4

5-6

More than 6

Will they be attending any of the family-friendly activities?* This field is required.

Yes

Planned Dates of Attendance* This field is required.

Friday, June 1st

Saturday, June 2nd

Sunday, June 3rd

Not Sure

Will You Require a Hotel?* This field is required.

Yes

Years at WSU (choose all that apply)* This field is required.

2010-2016

2003-2009

1996-2002

1989-1995

1982-1988

1975-1981

1968-1974

Your Spouse or Significant Other's Years at WSU (choose all that apply)* This field is required.

2010-2016

2003-2009

1996-2002

1989-1995

1982-1988

1975-1981

1968-1974

List your affiliated organizations, including organizations joined after attending WSU (Ex: Black Men On The Move, National Society of Black Engineers, etc.)

List your spouse or significant other's affiliated organizations, including organizations joined after attending WSU (Ex: Black Men On The Move, National Society of Black Engineers, etc.)

Shirt Size* This field is required.

Shirt Size For Your Spouse or Significant Other* This field is required.

Would like to receive special offers, news and updates from BLACKtie Alumni Weekend, its subsidiaries and other third party members?* This field is required.

Yes

Registration is not complete until fee is paid. Please select one of the Registration Options on the next page.

Payments are processed securely through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.

Registration Payment* This field is required.Please select the Double Registration option if you are registering yourself AND your spouse/significant other. Please note that registration fees are non-returnable and non-transferable.

My Bag

2018 BLACKtie Registration - Single
$40.00+Remove
Back
2018 BLACKtie Registration - Double
$75.00+Remove
Back

Uh-Oh! You chose the Single Registration option but you mentioned that you wanted to register your spouse/significant other. Please go back to the previous screen to select the Double Registration option.* This field is required.

I am only registering myself. I understand that by selecting the Single Registration option, my spouse/significant other will not be registered and will not receive any of the items/gifts included in the registration.

Uh-Oh! You chose the Double Registration option but it doesn't appear that you are registering your spouse/significant other. Please go back to the previous screen to select the Single Registration option.* This field is required.

I am only registering myself but I am selecting the Double Registration option with the intent of donating an extra $35 to the reunion. I understand that by donating the extra $35 to the reunion, I do not have the option of registering my spouse/significant other at a later time under this registration. Should I choose to register my spouse/significant other later, I will be required to complete a new registration form and pay a separate fee for their registration.

Click Review and Submit to review your entries. You are able to make changes as necessary.

BLACKtie Alumni Weekend Registration Form

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