Undergraduate Extra Delegate Registration

Undergraduate Registration

Please complete this form if you are an EXTRA delegate for the 181st Chi Psi Convention. If you are an official delegate of your Alpha, please register here: Undergraduate Delegate Registration.

Undergraduate Delegate Registration: Extra Delegates

First Name*
Middle Name*

If you do not have a middle name, please write "none."
Last Name*
Suffix
Preferred Name/Nickname*

For your name tag at Convention.
Date of Birth*
Alpha Designation*
Graduation Year (Expected)*
Position(s) Currently Held in Alpha*
Preferred Phone Number*
Preferred Email Address*
Which state is listed on your driver's license/government-issued ID?*

If you are an international student, please type "N/A."
If you are not a resident of the U.S., what is your country of residence?
Expected Spencer Institute Track(s)
- #1 Track
- Recruitment Track
- Rituals and Traditions Track
If you are unsure which track to select, please leave your selection blank, finish and submit the form, and then contact your #1.
Transportation Type*
- Flying
- Driving
- Train
Please note that as an extra delegate, you are expected to arrange your own travel to and from Raleigh, NC.
If driving or taking a train:

Add mode of transportation, arrival date and time, and any other relevant information.
Do you commit to attending Convention from Weds. 7/21-Sun. 7/25?*
- Yes
- No
Which city and state will you be traveling from for Convention on July 21?
Which city and state will you be traveling back to after Convention on July 25?
List any food allergies here.*
List any medical conditions here.*
Emergency Contact Name*
Emergency Contact Phone Number*
Other Notes About Travel Plans

Please include any other important notes about your expected travel plans here.

Follow Us on Social Media

Undergraduate Registration

Undergraduate Delegate Registration: Extra Delegates