2024 Fall Leadership Conference Registration Form

2024 Fall Leadership Conference Registration Form

Deadline: September 15
Please review your entries.

Upon submission, a confirmation email should be received containing a link to your completed form.

Please print and mail the completed form along with a check made payable to NEBRASKA FBLA by September 15 to:

FBLA FLC Registration
Grafton & Associates, P.C.
5935 S. 56th Street Suite A
Lincoln, NE 68516-3301

Thank you for registering for the Nebraska FBLA Fall Leadership Conference!
FBLA Chapter*
Adviser 1*
Adviser 1 - E-mail*
Adviser 1 - Cell Phone*

Area CodePhone Number
Adviser 2
Adviser 2 - E-mail
Adviser 2 - Cell Phone

Area CodePhone Number
Adviser 3
Adviser 3 - E-mail
Adviser 3 - Cell Phone

Area CodePhone Number
Name of Student Teacher Attending
Student Teacher E-mail
Check the FLC Site you will be attending:*

Kearney on Tuesday, September 24Fremont on Wednesday, September 25
Number of advisers/student teachers attending: *
Number of local officers attending:*
Number of non officer members attending:
May bring up to 4 non-officer members.
Total Attending
Amount Due (Grafton Code: 4200-01)
Please pay this amount.
Chapter Permission Form *

Upload a File
Please submit .pdf of the completed form. Cancelof

Dietary Restrictions and Special Needs
Please provide any special accommodations needed during the conference.
Please enter the names of the officers and members attending the Fall Leadership Conference.
Officer 1*
Officer 2*
Officer 3*
Officer 4*
Officer 5
Officer 6
Officer 7
Officer 8
Officer 9
Officer 10
Officer 11
Officer 12
Officer 13
Officer 14
Officer 15
Member 1
Member 2
Member 3
Member 4

Please review your entries.