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 Only: No charge** Yes, please register me for PRSA-OKC's Annual Shadow Day ONLY and coordinate a student(s) to shadow me.
	*Shadow Day & Lunch: $22 for PRSA Members** Yes, please register me for PRSA-OKC's Annual Shadow Day and luncheon, and coordinate a student(s) to shadow me.
	*Shadow Day & Lunch: $32 for Non-PRSA Members** Yes, please register me for PRSA-OKC's Annual Shadow Day and luncheon, and coordinate a student(s) shadow me.
	*Lunch Only: $22 for PRSA Members** Yes, please register me for PRSA-OKC's Lunch ONLY.
	*Lunch Only: $32 for Non-PRSA Members** Yes, please register me for PRSA-OKC's Lunch ONLY.
First Name*		Last Name*
Title *
Company*
Email*
Address*
City*
State*
Zip*
Phone*
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.