Please complete all applicable information and mark all choices.
Please duplicate this form for additional registrations.
Educator dormer: Registration, room and board (multi-occupancy)
$375 for registration received by 6/1/10. $425 for registration received after 6/1/10.
Student dormer: Registration, room and board (multi-occupancy)
$375 for registration received by 6/1/10. $425 for registration received after 6/1/10.
Educator commuter: Registration only (excludes meals and lodging)
$275 for registration received by 6/1/10. $325 for registration received after 6/1/10.
Student commuter: Registration only (excludes meals and lodging)
$275 for registration received by 6/1/10. $325 for registration received after 6/1/10.
Full Name:
Address:
City: State: Zip:
Home Phone: Email:
Gender: Male Female Classification: Student Educator
T-shirt Size: Small Medium Large Extra Large
Name of School:
Preferred Roommate:
Students Only (must be completed!):
Age: Year in school (as of Spring 2010):
Vocal Part: Soprano Alto Tenor Bass
I am interested in undergraduate credit from Butler Community College (additional cost)
Educators Only:
I am interested in graduate credit from Emporia State University (additional cost)
I am interested in undergraduate credit from Butler Community College (additional cost)


All registration forms must be accompanied by a $150 deposit.
Final payment due at registration July 11, 2010.
Check or money order payable to: Butler Showchoir Showcase
Return registration form and deposit to:
Butler Showchoir Showcase / P.O. Box 781425 / Wichita, KS 67278

For more information:
Valerie Lippoldt Mack: (316) 322-3224 or 733-3224 direct from the Wichita metro area
Fax: (316)322-3109 /