Online Registration Form

   
Name
College
Year
   
Rank top three labs - see dowloadable brochure
1.
2.
3.
   
Address
City
State
Zip Code
Telephone
Email Address
   
Scrub size Small
  Medium
  Large
  X-large
  XX-large
   
Attending Halloween Party? Yes
(Friday evening) No
   
 

Note: Please mail $25 to pre-order embroidered scrubs and
$15 to attend Alpha Psi Halloween Party.

Send to: Brandi Van Ormer, MSU-CVM, P.O. Box 6100, Mississippi State, MS 39759

Questions? Email vanormer@cvm.msstate.edu
 

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240 Wise Center Dr | P.O. Box 6100 | Mississippi State MS 39762 | 662-325-3432 | Legal