CONVENTION PROGRAM

Registration Form
XXnd Annual MOAA Chapters Convention- D A T E
Florida Council of Chapters

Fine Resort - Some City, Florida

Name: Rank: Service:
Your Street Address: MOAA Member No:
City State: ZIP:Chapter officer or Title:
Home Phone #: () E-mail address:
Chapter: Designated Voting Delegate: Yes No
Spouse/guests: (full names):
Enter all nicknames For Identification Tags:
Convention Lodging: Trade Winds Resort Other. If other, specify phone No:

REGULAR EVENTS

ALL REGISTRATIONS MUST BE RECEIVED BY XXX X, 2XXX	COST	NUMBER	TOTAL
1. Complete Convention Package (Includes items 2, 3, 4, & 5 below)	$xxx.00		$
2. Convention Registration Fee	$xx.00		$
3. All Hands Breakfast, Speaker, 0800 hrs, Wednesday, June 2, 1999	$xx.00		$
4. Gulf beach Bash - 2000 hrs Wednesday, June 2nd	$xx.00		$
5. Military Ball, Speaker, 1900 hrs - Thursday, June 3, 1999	$xx.00		$
6. SUB-TOTAL - Includes Registration and Selected Items 3 thru 5	.	.	$
7. Total Selected Special Activities From Page 2 of this Form	.	.	$
8. GRAND TOTAL - Make your check in this amount payable to "ST PETE ROC" and Mark it "For 1999 State Convention"	.	.	$

SUGGESTED DRESS: Military Ball: Men - Tux, dark business suit or dinner dress uniform
Women - Formal or cocktail dress. All other events -Florida casual wear as appropriate.
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SEATING FOR THE MILITARY BALL: Every effort will be made to seat registrants from
the same Chapter at the same or adjoining table. Groups desiring to be seated together
must submit their individual Registration forms together in the same envelope with a note
requesting such seating.

Mail this form and check to:
Any City Officers' Club
P O box xxxx
Any City, FL XXXXX

DON'T FORGET REGISTRATION DEADLINE
MAY 1, 2xxx
Table assignments at the Military Ball
based on date of receipt. Seating not assigned
at other events.