College and Career Fair Workshop Registration 2023 College & Career Fair Workshop Registration This is the 2023 form for the registration for the College & Career Fair. Today's Date* MM slash DD slash YYYY Name First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Please list the best phone number that we can reach you, if there are questions.Email* Enter Email Confirm Email How many will be attending the workshop(s) from your family?*Total number of people attending the workshop from your family.Names of Attendees* Please list the first and last names of all attendees, separating each name with a comma.Workshop Registration Fee* CHEO Member Family @ $25.00 CHEO Non-member Family @ $40.00 This family fee is for workshop attendance, whether you attend you attend one workshop or all 4 workshops.Donation Would you like to make a donation to the statewide work of CHEO?Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name CAPTCHA Δ
