79th Annual 3rd District Meeting
Registration Package
The Third District
Omega Psi Phi Fraternity, Inc.
April 12 – 15, 2012
Gamma Alpha Chapter
Roanoke, Virginia
Anthony R. Knight
Third District Representative
Otis “OJ” Jordan
District Marshal
(540) 562-1105
E-mail: [email protected]
Claude “Sport” Page
Deputy Marshal
(540) 915-0446
E-mail: [email protected]
Seventy-Ninth
Annual Third District Meeting
To the Brothers of the Third District:
The purpose of this communication is to welcome the Brothers of the Third District to the
City of Roanoke for the 79th Third District Meeting. Your host chapter (Gamma Alpha
Chapter) has been working diligently to make this an enjoyable meeting for everyone.
We look forward to entertaining you in April 2012 in our city.
Our goal is to ensure that you enjoy your stay while attending the District Meeting. A
variety of activities have been planned that we are certain you will enjoy.
If you have any questions, please do not hesitate to contact me at (540) 562-1105(h) or
(540) 353-0722 (c) or [email protected].
Fraternally Yours,
Otis Jordan
Brother Otis “OJ” Jordan
2012 District Marshal
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Seventy-Ninth
Annual Third District Meeting
REGISTRATION FORM
[PLEASE PRINT OR TAB THROUGH FORM]
Online Registration Is Coming Soon!
Name:
Control No.:
Chapter Name:
Graduate Brother: ______
Chapter No.:
Undergraduate Brother:_____
Your Mailing Address:
City:
State:
Phone (H):
(W):
Registering As [Check one]: Delegate:
Zip Code:
E-Mail:
Alternate:
Visiting Brother
National Officer Name:
Indicate: Former District Representative Name:
District Officer Name:
District No.
Position
Year(s)
Year(s)
REGISTRATION FEES
Note: Your Registration Fee includes: the 79th Anniversary Gift and Registration Packet and one each (1)
ticket to:
DR’s Reception- Thursday Night ( Jazz/Blues Night ), After Party, Leadership Breakfast,
Undergraduate Luncheon, Founders’ Banquet ( With Guess Speaker ) and 3rd Annual Prayer Breakfast
(Sunday Morning)
Note: Break-Out Session refreshments throughout the meetings
Shirt Size: ___Med ___ Lg ___ XL ___ XXL ___ 3XL ___ 4XL
Do you have any Dietary needs for meals? [Check one]
Yes
No
Please explain [for example ~ Vegetable or Fruit only, No meat, (Fish, Beef, etc.)]:
Undergraduate [Anytime]
$ 175.00 $
Early Registration through February 29, 2012
Late Registration (Begins March 1, 2012)
On-Site Registration
$ 190.00 $
$ 240.00 $
$ 280.00
Amount Enclosed For Registration:
ADDITIONAL TICKETS
March Down/Step Show Exhibition [Friday Evening]
Adult Comedy Show and Dance [ Friday Night] [ Registered Brothers]
Undergraduate Luncheon [Brothers Only]
Founders Banquet w/ Guest Speaker [Saturday Evening]
3rd Annual Prayer Breakfast [Sunday Morning]
*****
$
Qty
@
Qty
@
Qty
@
Qty
@
Qty
@
$ 10.00
$10.00
$40.00
$75.00
$10.00
$
AMOUNT ENCLOSED FOR ADDITIONAL TICKETS:
$
$
$
$
GRAND TOTAL ENCLOSED
$
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Seventy-Ninth
Annual Third District Meeting
The following registration fees apply:
Early
Brothers
$190 Through
Registration: February 29, 2012
Late
On-Site
$240 After
March 1, 2012
$280
Undergraduate Registration Fee - $175.00 – Anytime
Make checks payable to:
Third District Planning Committee
Please return completed form to: Third District Planning Committee
c/o Gamma Alpha Chapter
PO Box 12501
Roanoke, VA 24026
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Seventy-Ninth
Annual Third District Meeting
2012 Third District Meeting
Event Agenda
(Tentative)
Thursday, April 12, 2012
8:00 a.m. – 2:00 p.m. – Third District Meeting / Golf Activity
11:00 a.m. – Social Action Program
11:00 a.m. – Exhibits/Vendors Open
12 Noon – 10:00 p.m. – Registration Open
5:00 p.m. – 6:30 p.m. – Executive Council Meeting
7:00 p.m. – 9:00 p.m. – District Representative Welcome Reception (Jazz/Blues)
9:00 p.m. – 11:30 p.m. – After Party (Registered Brothers & Quettes)
Friday, April 13, 2012
7:00 a.m. – 5:00 p.m. – Registration Open
7:00 a.m. – 9:00 a.m. – Leadership Breakfast
9:00 a.m. – 5:00 p.m. – General Session
9:00 a.m. – 9:00 p.m. – Exhibits/Vendors
12 Noon – 1:30 p.m. – Third District Foundation Meeting and Lunch
6:00 p.m. – 8:00 p.m. – March Down Competition Show – (Wm Fleming High School)
9:30 p.m. – 1:00 a.m. – Friday Night Show and Dance
Saturday, April 14, 2012
7:00 a.m. – 1:00 p.m. – Registration Open
7:00 a.m. – 9:00 a.m. – Life Membership Foundation Breakfast
9:00 a.m. – 12:00 p.m. – General Session
9:00 a.m. – 7:00 p.m. – Exhibits/Vendors
12 Noon – 2:00 p.m. – Undergraduate Luncheon
2:30 p.m. – 6:00 p.m. – Undergraduate Activities & Picnic (Wm Fleming High School)
3:00 p.m. – 5:30 p.m. – Talent Hunt Program (Wm Fleming High School)
7:00 p.m. – 8:00 p.m. – Cocktail Reception
8:00 p.m. – Until – Founders’ Banquet (w/Guest Speaker)
Sunday, April 15, 2012
8:00 a.m. – 10:30 a.m. – 3rd Annual Prayer Breakfast and Ecumenical Service
11:00 a.m. – 1:00 p.m. – Third District Executive Council Meeting
****IS NOT INCLUDED IN CONFERENCE REGISTRATION FEES****
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Seventy-Ninth
Annual Third District Meeting
GAMMA ALPHA CHAPTER – HOST CHAPTER
Host Hotel:
The Hotel Roanoke & Conference Center
A DoubleTree by Hilton Hotel
110 Shenandoah Avenue
Roanoke, Virginia 24016
Reservations: 1-866-594-4722
Local: 1-540-985-5900
Website: http://doubletree.hilton.com/en/dt/groups/personalized/R/ROASWDT-OPP20120412/index.jhtml;jsessionid=2IKH0Y5FSJ43MCSGBJN222Q
Room Rates:
$109.00 Single or Double occupancy
for “Run of the House” Rooms
“Ask for Omega Psi Phi rate”
Suites will be assigned by the Third District Representative
RESERVATIONS REQUESTED AFTER – MARCH 15, 2012
WILL BE ACCEPTED BASED UPON AVAILABILITY
CHECK IN TIME: 3:00 p.m.
CHECK OUT TIME: 12:00 Noon
HOTEL GUEST PARKING IS $7.00 – SELF PARKING (OVERNIGHT)
VALET PARKING IS $12.00 (OVERNIGHT)
DAILY PARKING IS $6.00 (NON-REGISTERED HOTEL GUEST)
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Seventy-Ninth
Annual Third District Meeting
Maps/Directions
View Larger Map
Driving Directions
From DC and Northern VA – West I-66 to South I-81
Exit 143 (I-581 South) to Exit 5. Cross Wells Avenue and continue to the main entrance of the hotel.
From Tidewater and Hampton Roads - West I-64 to South I-81
Exit 143 (I-581 South) to Exit 5. Cross Wells Avenue and continue to the main entrance of the hotel.
From North or South I-81
Exit 143 (I-581 South) to Exit 5. Cross Wells Avenue and continue to the main entrance of the hotel.
From 220N (Martinsville)
220N becomes I-581N. Take exit 4E- (Orange Avenue). Take first right at traffic light onto Williamson Road. After the third
traffic light, turn right on Shenandoah Avenue. Take the first right to main entrance of the hotel.
From 460W (Lynchburg)
460 becomes Orange Avenue. Turn left at the traffic light at Williamson Road and Orange Avenue. After the third traffic
light, turn right on Shenandoah Avenue. Take the first right to main entrance of the hotel.
Click on the link below to get customized directions to the hotel:
http://doubletree1.hilton.com/en_US/dt/hotel/ROASWDT-Hotel-Roanoke-Conference-Center-aDoubleTree-by-Hilton-Hotel-Virginia/directions.do#localmap
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Seventy-Ninth
Annual Third District Meeting
MARCH DOWN
STEP SHOW ~ MARCH DOWN ENTRY FORM
APRIL 13, 2012
[Please print or type - Use black ink only]
Contact Person:
Chapter Name:
City:
State:
Phone (H):
(W):
Zip Code:
E-Mail:
Rules of Engagement:
1. All Step Show ~ March Down participants must be financial members of the Third District
of Omega Psi Phi Fraternity, Inc.
2. Any team that exhibits any vulgar language and/or obscene gestures will be automatically
disqualified.
3. All shows should be limited to fifteen (15) minutes.
4. A prize will be given to the first place winner.
Brother’s Name
Control Number
Chapter
Note: This form must be received by March 31, 2012 to:
3D Step Show
c/o Gamma Alpha Chapter
P.O. Box 12501
Roanoke, VA 24026
8
CHAPTER DELEGATE CREDENTIAL
[PLEASE PRINT OR TYPE FORM FILL]
Today’s Date:
Chapter Information:
Chapter Name and Number:
P. O. Box:
City, State, Zip Code:
Delegate Information:
Registration as [Select one]:
Primary Delegate:
Alternate:
Name of Primary Delegate or Alternate:
Street Address – City, State, Zip Code of Primary Delegate or Alternate:
City:
State:
Third District Card Number:
Zip:
Fraternity Control Number:
E-Mail Address:
CERTIFICATION
To:
Brother District Keeper of Records and Seal:
This is to certify that the Brother whose name and information appears above is a bona fide member of
this chapter and is in good financial standing. He has been duly selected as a delegate or alternate and is
to have all the rights and privileges appertaining thereunto this Annual Third District Meeting.
Fraternally yours,
Basileus,
Chapter
, Chapter Keeper of Records and Seal
ACKNOWLEDGEMENT
District KRS Initials:
Credential Chairman Initials:
NOTE: Send this form to the District KRS at least fifteen (15) days* prior to the
District Meeting. (*March 29, 2012)
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Seventy-Ninth
Annual Third District Meeting
OMEGA PSI PHI FRATERNITY, INC.
Third District Meeting / Golf Activity
WHAT:
WHEN:
WHERE:
Golf Activity
April 19, 2012
Blue Hills Golf Club
2002 Blue Hills Circle, NE
COST:
Roanoke,VA
$200 per foursome or $50 per
individual*
(Includes round of golf with cart)
DETAILS:
We have scheduled a golf activity for those Brothers who are
interested in playing golf as part of the Third District Meeting.
 Shotgun Start @ 10:00 a.m.
 Light lunch will be served
 Awards will be presented to the winners
INTERESTED:
[ ] Yes
[ ] No
Contact: Brother Orren Prunty @ 540.293.4973 or
E-mail: [email protected]
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Seventy-Ninth
Annual Third District Meeting
OMEGA PSI PHI FRATERNITY, INC.
Third District Golf Activity
April 19, 2012
Shot Gun Start @ 10.00AM
Blue Hills Golf Club
2002 Blue Hills Circle, NE
Roanoke, Virginia
Foursome @ $200 --- Individuals @ $50
________________________________________________________________
Registration Form
_____ Yes I will participate in the Third District Golf Activity on April 19, 2012.
I will have #______ players on my team. Enclosed is my check in the amount of $__________.
Name(s) of Players
___________________________
__________________________
____________________________
No I will be unable to play. However, please accept my enclosed donation of $_________.
Name: _________________________ Phone#: ______________________
Address________________________________________________________
City: _____________________________State: _______ Zip: _____________
Please make all checks payable to: Gamma Alpha Chapter, Omega Psi Phi Fraternity,
Inc.
Kindly R.S.V.P. by April 1, 2012
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Seventy-Ninth
Annual Third District Meeting
THIRD DISTRICT SOUVENIR JOURNAL
SAMPLE PAGE LAYOUT
$135.00/$180.00*
$40.00
$90.00
Business
Card
$120.00
Quarter
Page
Order Advertisement type requested
Business Card
Quarter Page
Half Page
Full Page – Black and White* (Received by March 15, 2012)
Full Page – Black and White (Received by March 31, 2012)
Full Page – Color* (Received by March 15, 2012)
Full Page – Color (Received by March 31, 2012)
Single Line(s):
Patron and Friends of Omega (list names on separate page)
Life Member Name: _____________________________________
Life Member No:
[Indicate Name]:
Full Page
Black/White
----------------
___________________________
In Honor of
In Memory of [Indicate Name]:
Legacy
List Name of Legacy(s): ______________________
______________________
20, 25, 30, 35, 40, 45, 50, 55, 60, 60+ Years of Omega
Service [Indicate No. of Years]: _____
TOTAL AMOUNT ENCLOSED
$175.00/$240.00*
Half
Page
Full Page
Color
@
Unit
Price
$40.00
$ 90.00
$ 120.00
$ 135.00
$ 180.00
$ 175.00
$ 240.00
@
$ 10.00
@
$ 15.00
@
@
$ 15.00
$ 15.00
@
$ 25.00
@
$ 15.00
Qty
@
@
@
@
@
@
Price
Name of Individual or Organization:
Chapter Name:
Address:
City/State/Zip:
Telephone No.:
*Note:
E-Mail:
Early Bird applies to Third District Chapters only!!
$135.00 for all full page black/white ads that are in by March 15th
$175.00 for all full page color ads that are in by March 15th
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Seventy-Ninth
Annual Third District Meeting
Patron List
Patron listings will be listed under
“Congratulations and Best Wishes for A Successful
79th Annual Third District Meeting”
$10.00 per line
Please print legibly
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Seventy-Ninth
Annual Third District Meeting
Make checks payable to the:
Third District Planning Committee
Please return this form(s) with payment, and camera-ready advertisement(s)
Deadline, March 31, 2011 to:
Third District Planning Committee
C/o Gamma Alpha Chapter
P.O. Box 12501
Roanoke, VA 24026
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Seventy-Ninth
Annual Third District Meeting
QUETTE REGISTRATION FORM
GAMMA ALPHA CHAPTER
ROANOKE, VA
APRIL 12-15, 2012
Quette Name:
Brother’s Name:
Chapter Name:
Your Mailing Address:
City:
Phone (H):
State:
(C):
Zip Code:
E-Mail:
Early Registration thru February 29, 2012
$ 130.00 $
Late Registration (Begins March 1, 2012)
(On Site Registration)
$ 145.00 $
$ 160.00
Amount Enclosed For Registration:
****
$
Quette registration fee includes entrance/tickets to the following (tentative) Activities:










Gift Bag
Quette Reception/Mixer and access to Hospitality Suite
District Representative Welcome Reception (Jazz/Blues - Thursday Evening)
After Party (Thursday Evening)
Continental Breakfast (Friday and Saturday)
Brunch/Luncheon (Friday) (Location TBD)
Luncheon (Saturday) at Hotel Roanoke (Location TBD)
March Down Competition Show - (Location TBD)
Adult Comedy Show and Dance - (Location TBD)
3rd Annual Prayer Breakfast and Ecumenical Service
ADDITIONAL TICKETS
Qty
@
Quette Bunch/Luncheon (Location TBD) [Friday]
Qty
@
March Down Competition Show [Friday Evening]
Qty
@
Adult Comedy Show and Dance [Saturday Evening]
Qty
@
Quette Luncheon at Hotel Roanoke [Saturday]
Qty
@
3rd Annual Prayer Breakfast and Ecumenical Service
Qty
@
Founders’ Banquet ***Not Included With Quette Registration***
$ 30.00
$ 10.00
$ 30.00
$ 35.00
$ 10.00
$ 75.00
AMOUNT ENCLOSED FOR ADDITIONAL TICKETS:
$
$
$
$
$
$
$
GRAND TOTAL ENCLOSED
$
Do you have any Dietary needs for meals? [Check one]
Yes
No
Please explain [for example ~ Vegetable or Fruit only, No meat, (Fish, Beef, etc.)]:
15
Seventy-Ninth
Annual Third District Meeting
Make checks payable to:
Gamma Alpha Quettes
Please return completed form to:
Gamma Alpha Quettes
C/o Gamma Alpha Chapter
PO Box 12501
Roanoke, VA 24026
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Seventy-Ninth
Annual Third District Meeting
2012 Third District Meeting
Quette Event Agenda
(Tentative)
Quette Registration Fee provides Entrance/Tickets to all activities
and events listed below except for the Founders’ Banquet
Thursday, April 12, 2012
12 Noon – 10:00 p.m. – Registration Open
3:00 p.m. – 5:00 p.m. – Quette Early Bird Mixer/Reception
7:00 p.m. – 9:00 p.m. – District Representative Welcome Reception (Jazz/Blues)
9:00 p.m. – 11:30 p.m. – After Party (Registered Brothers & Quettes)
Friday, April 13, 2012
7:00 a.m. – 11:00 a.m. – Registration Open
7:30 a.m. – 8:30 am – Quette Morning Walk
8:00 a.m. – 9:00 a.m. – Continental Breakfast
11:30 a.m. – 2:00 p.m. – Lunch (Location TBD)
6:00 p.m. – 8:00 p.m. – March Down Competition Show – (Location TBD)
9:00 p.m. – 1:00 a.m. – Friday Night Show and Dance (Location TBD)
Saturday, April 14, 2012
7:00 a.m. – 12 Noon – Registration Open
7:30 a.m. – 8:30 am – Quette Morning Walk
8:00 a.m. – 9:00 a.m. – Continental Breakfast
12:00 Noon – 2:00 p.m. – Quette Luncheon (Hotel Roanoke)
3:00 p.m. – 5:30 p.m. – Talent Hunt Program – (Location TBD)
7:00 p.m. – 8:00 p.m. – Cocktail Reception
8:00 p.m. – Until – Founders’ Banquet (w/Guess Speaker) ***
Sunday, April 15, 2012
8:00 a.m. – 10:30 a.m. – 3rd Annual Prayer Breakfast
17