2019 SLC Registration Summary Form
**The forthcoming confirmation email upon submitting this form must be printed and mailed with payment to Grafton & Associates, P.C. (addr. on email) - NOT to Nebraska FBLA. DEADLINE: February 8, 11:59 p.m.
Email of Adviser completing this form
(Needed for receiving auto-generated confirmation of entry.)
Adviser(s) attending SLC
Student Teacher(s) attending SLC
Student Teacher 1
Student Teacher 2
Fee includes one (1) Meal on Friday evening.
Members - $71 each
Enter number of members attending (do not include your state officer here)
State Officer(s) - Fee Waived
Adviser(s) - $71 each
Chaperones + Student Teacher(s) - $46 each
ENTER 0 IF NOT APPLICABLE.
Chaperone/Student Teacher total
Total Attending SLC
Registration Fee Subtotal [4200-03]
Scholarship Fund and Star Volunteer Award
**If participating in either or both, please upload or indicate completion of the appropriate required form.
Scholarship Fund [4820-03]
1) IF NOT APPLICABLE, ENTER 0. 2) INCLUDE THE AWARD FEE IN YOUR REGISTRATION CHECK. (minimum $50 donation)
Upload completed Scholarship Fund Form
Required to receive special recognition for donation.
Online Star Volunteer Award form submitted
# of Star Volunteer Awards
1) IF NOT APPLICABLE, ENTER 0. 2) SUBMIT ONLY IF A CHAPTER HAS A NOMINEE. 3) COMPLETE THE ONLINE NOMINATION FORM. 4) INCLUDE THE AWARD FEE IN YOUR REGISTRATION CHECK.
Star Volunteer Amount Due [4250-03]
Scholarship Fund and Star Award total amount due
Scholarship Fund+ $25 per Star Volunteer Award
TOTAL SLC REGISTRATION DUE
Please let Karen or Jacqui know if calculations on this form do not match yours.
Total Amount Due:
Make check payable to Nebraska FBLA. Mail check with the confirmation email to Grafton & Associates, P.C. , 5935 S. 56th St STE A
Chapter Permission Form - Please upload as PDF
Should be Empty:
Now create your own JotForm - It's free!
Create your own JotForm