2026 NPGERC Conference Registration Form

Full Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Lodge Information:

Lodge Name * No.:Lodge Number *
State Association*
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PGER Registration
$200.00

Super Hero & Villains Theme Dance (Non-Member)
Friday night, get ready for some fun with our Super Heroes & Villains theme! Start planning your look now and take advantage of October Halloween sales for the perfect costume.

$20.00 Quantity

Total

$0.00
Cash AppZelle
PLEASE SELECT AND SUBMIT YOUR PAYMENT BEFORE YOU REGISTER
Zelle: npgercouncil@gmail.com
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