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: $_______
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.
Press the 'BACK' button to return to the Home Page.
