2022 Leadership Summit

First Name(Required)

Last Name(Required)

School(Required)

Chapter(Required)

PSE Membership(Required)

Which Leadership Position do you hold?(Required)

Arrival Time(Required)

Departure Time(Required)

Transportation: How will you be arriving at/departing from the Leadership Summit?(Required)

Phone Number(Required)

Email(Required)

Gender(Required)

Would you like to purchase a PSE polo shirt?

The cost of a PSE polo is $50. PSE HQ will place the order for your polo and send you an invoice for $50.

Preferred Shirt Type

Shirt Size

Do you consider yourself a Night Owl, Early Bird, or Both?(Required)

Please provide the first and last name of your emergency contact.(Required)

Emergency Contact Phone Number(Required)

Dietary Restrictions(Required)

Please list any other allergies/intolerances you may have(Required)

If you have a disability and/or health issue that we should be aware of, please specify here(Required)

Please list any COVID-19 related concerns you have as you prepare to attend the event(Required)

Liability, Cancellation, and Media Release Acknowledgement(Required)

I agree to the following terms

I hereby release Pi Sigma Epsilon, its officers, directors and employees from any and all claims, damages and liabilities incurred by me or on my behalf during the 2022 PSE Leadership Summit, including but not limited to bodily injury, host liquor liability and contractual liability CANCELLATION POLICY: Cancellations must be emailed to events@pse.org. If you can no longer attend, please have a replacement (of the same sex) ready to take your place. Cancellations received after 07/22/2022, with no replacement provided, may be charged $150 for the cost of meals, hotel room, and event materials. MEDIA RELEASE: PSE periodically use electronic and traditional media (e.g., photographs, video, audio recordings, testimonials) for publicity and educational purposes.