NAME:

ADDRESS: 

CITY: STATE: ZIP: 

TELEPHONE NO (include area code): 

EMAIL ADDRESS: 

SPOUSE'S NAME: 

Please check or complete the appropriate boxes:

$170 per couple

$115 single

TOTAL NO. ATTENDING:

Dues $20

TOTAL AMOUNT DUE:
 
 

If you will be bringing a guest(s) please include their name(s):

NAME:

NAME:

This form may be printed and mailed along with your check to James E. Aker, 6447 Sauterne Drive, Hamilton, OH 45011. Or you may submit this form via email by clicking on the SUBMIT button at the bottom of this page and pay when you arrive at the reunion. Please make your check payable to U.S.S. DES MOINES.

I will pay at reunion
I will mail a check