|
Select your top three choices from
the category list below. |
| 1.
Category* :
A value is required. |
Deck* :
A value is required. |
Price* :
A value is required. |
| 2. Category:
|
Deck:
|
Price:
|
| 3. Category:
|
Deck:
|
Price:
|
Please list the legal
name and birthdate of each roommate. |
* Note: You
are required to fill in at least one roommate below. [ Month / Day / Year ] |
| Roomate 1 |
|
|
| Last:
A value is required. |
First:
A value is required. |
Middle:
|
Month:
Please select an item. |
Day:
Please select an item. |
Year:
Please select an item. |
| Roomate 2 |
|
|
| Last:
|
First:
|
Middle:
|
Month:
|
Day:
|
Year:
|
| Roomate 3 |
|
|
| Last:
|
First
:
|
Middle:
|
Month:
|
Day:
|
Year:
|
| Roomate 4 |
|
|
| Last:
|
First:
|
Middle:
|
Month:
|
Day:
|
Year:
|
If your roommate(s) is/are
paying separately, your roommate(s) must also
complete
a Registration Form. Are you paying
for your roommates? |
*
Yes
No |