Fellowship Conference Payment Form

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Cell Phone (for conference related questions)*

Registration Fee*

This includes: conference sessions, meals, and special programs, and a hotel room on Tuesday evening July 19 (your own room). Please note that this conference is highly subsidized by the OU Women's Initiative.

Standard Fee - $350.00
I will share a room with a friend Tuesday evening for a discounted rate of $275.00
I will not be staying at the hotel on Tuesday evening - $275.00

Name of friend:*

Please note: you and your friend must submit your payments forms within 2 business days of each other in order to secure your room and discounted rate.

Monday evening July 18*

We welcome you to join us at the hotel on Monday evening beginning at approximately 7:00 PM. Dinner will be served at approximately 7:00 PM. Please note: We will be running a 1-day program for our fellowship participants on Monday at the hotel. Some of the evening programming may be open to all guests. If we have a large number of women joining us on Monday evening, we will provide parallel program options. The additional cost is $200.

I will arrive Tuesday morning at the beginning of the conference (I am not staying over Monday evening).
I am joining the program at the hotel Monday evening July 18 for an additional $200.

Do you have a code for your registration?*

No
Yes

Code:

Total

$0.00

Please click here so that you receive all necessary conference information.

Yes, I would like to subscribe

Consent*

I understand that if this reservation is canceled before June 17, 2022, 50% of the fee is refundable. After June 18, 2022, no part of this fee is refundable.

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

PAYMENT FORM