U.S. NAVCOMMSTA LONDONDERRY Alumni Association "Reunion 2009 - Charleston SC"

Attendee Registration Form (please print)
 

Reunion Event and Tour Tickets may be ordered on a first come, first serve basis through the Registration
Deadline of July 17, 2009.
Provide all information so name tags can be prepared and confirmations sent.

Member Name: _____________________________________________ Nickname (if any): ___________
Rating (or) Civilian: _________ Years in Derry: From: MM/YY ____________ To: MM/YY _____________
Mailing Address: ________________________________________________________________________________
E-mail Address (if any): __________________________________________________________________________
Spouse/Guest Name (include Maiden Name if a “Derry Bride”): ___________________________________________
Names of family members for whom you are purchasing tickets, along with their relationship to you:
______________________________________________________________________________________________
Other Guests Names (if any):
______________________________________________________________________________________________

If you are interested in participating in either of the following two additional events, please circle which and include
the number of participants.
The golf organizer will provide information on golf, including cost, at a later date.

Tommy Condon’s Irish Pub (we must give them a number!): ____ Golf Tournament (number): ___


Reunion Administration Fee                    Total Cost: $2.00

Friday, September 18th, Fort Sumter Tour

Ticket Price:  $14.00 per person      Number of tickets desired: _____              Total Cost: $_______

Saturday, September 19th, Patriot's Point Tour 

Ticket Price:  $12.00 per person      Number of tickets desired: _____              Total Cost: $_______

Friday, September 18th, Members Reception

         Ticket Price:  $5.00 per person      Number of tickets desired: ______            Total Cost: $_______

Saturday, September 19th, Members Dinner Dance

Ticket Price:  $35.00 per person    Number of tickets desired: _____              Total Cost: $_______ 

Please add the above five Total Cost figures to calculate
your TOTAL PAYMENT due at this time:  --------------------- >  TOTAL PAYMENT:   $__________

METHOD OF PAYMENT

Pay by personal check in U.S. dollars drawn on a U.S. Bank, OR by International Bank Draft in 
U.S. Dollars drawn on a U.S. Bank, OR by International Money Order in U.S. Dollars, all made payable to: 
USNLAA. 
Mail this form, AND YOUR TOTAL PAYMENT prior to July 17, 2009 to:

USNLAA, P.O. Box 108, New Boston, MI 48164-0108.

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