MWPHGL of IN 2024 Fall Workshop Registration Form

Most Worshipful Prince Hall Grand Lodge of Indiana Fall Workshop Registration Form

November 2, 2024 at 9AM EST, 3678 Prince Hall Dr., Marion, IN 46953
Advance Registration Fee of $25, Deadline is 5PM EST, October 26, 2024.

Late Registration fee will be $40 if paid after 5PM EST on October 26, 2024 and before November 2, 2024 5PM EST. Onsite Registration fee on November 4, 2023 will be $40.00. With Onsite Registration you are not guaranteed a meal.
Current Title*

MWGMPMWGMPMWMSWJWTreasurerSecretarySDJDSSJSMarshallTylerMM
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 Fall Workshop Payment Method*

Electronic PaymentMailing Payment In

Your registration payment must be received before November 3, 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 Vincent N. Sykes, Sr. at P.O. Box 26104, Indianapolis, IN 46226.
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Most Worshipful Prince Hall Grand Lodge of Indiana Fall Workshop Registration Form