REUNION REGISTRATION FORM

U.S.S. DES MONIES REUNION REGISTRATION FORM-July 24, 25, 26TH, 2019

Please print all information requested below so we may accurately document your attendance. Make checks payable to" "U.S.S. Des Moines Reunion Association" and mail them to Barry

* Indicates required field

Name *

First

Last

Street Number *

City *

State *

Zip Code *

Email *

Phone Number (xxx) xxx-xxxx *

Name - of Spouse *

First

Last

Name - of guest 01 *

First

Last

Name - of guest 02 *

First

Last

Name - of guest 03 *

First

Last

Name - of guest 04 *

First

Last

Number of persons at $280 per couple X *

Dollar Total *

Number of persons at $140 per single X *

Dollar Total *

$25 Annual Dues (if not paid): *

Total Number Attending *

Total Amount Due: $ *

FOR OFFICE USE ONLY *

Reunion Amount Paid: $ *

Date Reunion Fee Paid: *

Check Number: *

Amount of dues paid: $25/Year *

Date yearly dues paid: *

Check Number *

Submit