Pack Family Regions Participation Form

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Thank you for your interest in the Pack Family Regions program. Please complete this form to keep you informed about news and events on campus and in your region. Go Pack!

Last Name *

First Name *

Address *

City *

State *

Zip *

Email Address *

Cell Phone Number *

Student's Name *

Student's Classification *

First-Year

Second-Year

Third-Year

Fourth-Year

Required

Student's Class *

2025

2026

2027

2028

2029

2030

2031

2032

Identify your region from the following: *

** International (Outside of the U.S.)

Region 1 (Florida, Georgia, North Carolina, South Carolina, Virginia)

Region 2 (DC, Delaware, Maryland, Pennsylvania, West Virginia)

Region 3 (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Rhode Island, Vermont)

Region 4 (Iowa, Kansas, Michigan, Minnesota, Nebraska, Wisconsin)

Region 5 (Alabama, Arkansas, Louisiana, Mississippi, Oklahoma, Eastern Texas, Puerto Rico)

Region 6 (Arizona, California, Colorado, Hawaii, Nevada, New Mexico, Western Texas, Utah)

Region 7 (Alaska, Idaho, Montana, North Dakota, Oregon, South Dakota, Washington, Wyoming)

Region 8 (Illinois, Indiana, Kentucky, Missouri, Ohio, Tennessee)

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