MWPHGL of IN Spring Workshop Registration Form

Current Title*

First Name*

Please Enter your First Name and Middle Initial after your Pre-Filled Title

Last Name*

Please Enter your Last Name and Suffix (i.e. Jr, Sr,) if applicable

E-mail*

Lodge Name & Number*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Mobile Phone Number*

Home Phone Number if different from above

Do you prefer to receive Grand Lodge Communications via E-Mail or Post Office?*

MWPHGLIN Spring Workshop Payment Method

Electronic PaymentMailing Payment In

MWPHGL of IN Spring Workshop Payments

Advanced Registration Fee due before March 25, 2023$25.00

Quantity
Item subtotal:$0.00

Late Registration Fee due after March 25, 2023$35.00

Quantity
Item subtotal:$0.00

Total $0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Your registration payment must be received before March 29, 2023. All mail in payments should be made out to MWPHGL of IN if you are paying with a cashiers check, check or money order. Mail them to the RW Grand Secretary Jeffrey D. Mathis at P.O. Box 26104, Indianapolis, IN 46226.

Most Worshipful Prince Hall Grand Lodge of Indiana Spring Workshop

Advance Registration Fee of $25, Deadline is March 25, 2023

Payment Methods