Delta Pi 50th Reunion Registration












Registration Package ($100.00) Includes:


Game tickets will not be offered as part of the package. Please visit Ticket Master to purchase tickets to the Jackson State University vs. Alcorn State University Capitol City Classic football game.





Last Name: First Name:
Address1: Address2:
City/State/Zip:
Home Phone: Work Phone: ext.
Year Initiated:
E-mail Address:
Estimated Time of Arrival:
Shirt Size:

I will forward the stated amount within 2-5 business days to the address below or my registration will be considered null and void.
I have read and understand the registration information and the events I have chosen to participate in.
YES NO

Make Checks Payable to: Delta Pi 50th Reunion

Please print this form and mail it along with a money order or cashier's check ONLY to:
Jackson State University Development Foundation
P.O. Box 17144
Jackson, MS 39217