University:

Council Type: Will you be using the PNM Companion App? Address, City, State, and Zip:

Advisor/Primary Contact Name:

Advisor/Primary Contact Email Address:

Advisor/Primary Contact Phone Number:

Secondary Contact Name:

Secondary Contact Email Address:

Secondary Contact Phone Number:

Billing Contact Name:

Billing Contact Email:

Billing Contact Number:

Registration Fee Type:

Date Registration Opens:

Date Registration Closes:

Recruitment Start Date:

Recruitment End Date / Bid Day:

Number of Chapters Participating In Recruitment:

Will TechniPhi need to provide the training? Yes No N/A

iValU and weValU can now be ordered directly through CampusDirector. To order, please answer the following questions:

Would you like to implement iValU for $1/pnm on your campus? Yes No Would you like to implement weValU for $100/chapter on your campus? Yes No

Is this your first time using CampusDirector? Yes No Are you an NIC Charter Member? Yes No IFC Only

Payment Types

$150 setup fee for all new clients

Pricing plan / Estimated number of PNMs:

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Payment Types