Shadow Day - Student Form

Ethics Meeting and Shadow Day Professional's Registration			back to the Shadow Day Main Page * Denotes Required Field

Please complete the below form to register for Shadow Day 2009 and/or the Ethics meeting luncheon
	*Shadow Day & Lunch:** Yes, please register me for PRSA-OKC's Annual Shadow Day and coordinate a student to shadow me.
	Lunch Only* Yes, please register me for PRSA-OKC's Lunch ONLY.
First Name*		Last Name*
Title *
Company*
Email*
Address*
City*
State*
Zip*
Phone*
Would you like to participate in the luncheon?*
	Yes, $22 if PRSA Member Yes, $32 if Non-PRSA Member No
How many students can you host?

Please include additional comments if you wish:

		If you wish to pay by credit card, please complete the above form and the resulting "success" page will then give you the option to pay via PRSA-OKC PayPal account.