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BBC - Highlander 2013 Registration Form
May 14 - 17, 2013

Items with an * indicate a required field.
Please provide the following contact information
First Name *
Last Name *
Address Line 1 *
Address Line 2
City *
State *
Zip *
Home Phone
Cell Phone
E-mail address *
How did you learn about the Highlander?
 
Please select course option
Ball State University Travel Option: $605  Payment in full ($605)
  Paying $200 deposit with remaining balance due by April 14, 2013.
Personal Travel Option: $405  Payment in full ($405)
  Paying $200 deposit with remaining balance due by April 14, 2013.
 
Please select payment method
Payment Method
Check made payable to BSU can be mailed to Ball State University, Building Better Communities, Carmichael Hall Room 104, Muncie IN 47306. If you selected Credit Card Payment, please call Suzie Jones at (765) 285-2772 with your card information.

Also, you can print this form and fax the completed registration to attn: Suzie Jones at 765-285-4989.