65th NC Alphas District Conference

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Association of North Carolina AlphaMen

PO Box 141 Gastonia, NC 28053

info@ncalphas.org

www.ncalphas.org

Full Name

First NameMiddle NameLast Name
Email
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Phone Number
Format: (000) 000-0000.
Are you a Life Member
Life Membership ID
AlphaMX ID
Birth Date

MonthDayYear
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Are you District Leadership?
Select your Leadership Title
Are you a District Guest?
Please provide your title
If you are a District Guest, please provide your Chapter
Will your spouse/ significant other participate in the Yellow Rose Experience?

Chapter Name
Chapter Key
District Area
Brother Type
Are You A Delegate

Luncheons and awards reception are included in the delegate registration price but please let us know if you plan to attend, for planning purposes.
Will you attend the Fraternal Luncheon
Will you attend the Oratorical Luncheon
Will you attend the Awards Reception
Indicate your desired Alpha PHIt activity

Select Ticket Purchased

Registration Type

Neophyte

This selection is for Fall '25 and Spring '26 Brothers.

Free

Paid by Chapter Invoice

Each Chapter received an invoice number. If your Chapter is paying for your registration, once the costs have been paid, please retrieve your Chapter's invoice number from a member of your Executive Leadership Team and place it in the section below.

Free

Badge Only

$150.00

Yellow Rose Experience

$175.00

Delegate - College

$200.00

Non Delegate - College

$200.00

Delegate - Alumni

$280.00

Non Delegate - Alumni

$280.00

District Guest

$280.00

District Leadership

Please use if you are a part of the executive leadership team.

$280.00 Quantity

NC Alphas Steps Show

$30.00 Quantity

Miss Old Gold & Black Pageant

$30.00 Quantity

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Total

Chapter Invoice Number
Place Chapter Invoice Number here if the Chapter is paying for your registration.
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Registration Type*

Registration Type