| Click Here for a
Printable Form It is different from the form below. Note $5 charge for
shipping shirts. |
REGISTRATION FORM |
If you need a .pdf Reader, Click this button.
 |
NAME______________________________________________RANK__________SERVICE_______
CHAPTER___________________________________________CURRENT
OFFICE_______________
ADDRESS_____________________________CITY__________________________STATE____ZIP____
TELEPHONE_________________________E-MAIL__________________________________________
SPOUSE/GUEST_____________________
NAMES AS DESIRED ON
BADGES___________________________/____________________________
SPECIAL
REQUESTS____________________________________________________________________
| EVENT |
COST (PER
PERSON) |
NUMBER/TOTAL |
|
EVENTS PACKAGE
(Includes Registration plus Events 1,2,3,4) |
$ 115 |
________/$______ |
| REGISTRATION (Must
be registered to attend any event) |
$ 25 |
________/$______ |
| 1. PRESIDENT�S RECEPTION |
$ 10 |
________/$______ |
| 2. BREAKFAST & MEMORIAL
SERVICE |
$ 15 |
________/$______ |
| 3. CARIBE CARNIVAL/BANQUET |
$ 35 |
________/$______ |
| 4. MILITARY BALL/BANQUET |
$ 40 |
________/$______ |
| 5. LADIES FASHION LUNCHEON |
$ 20 |
________/$______ |
| 6. GOLF |
$ 40 |
________/$______ |
| 7. TENNIS |
$ 15 |
________/$______ |
| 8. BRIDGE |
NO COST |
________/$______ |
| |
|
|
| FRIDAY TOURS |
Time |
COST |
NUMBER/TOTAL |
| 9. BAY TOUR |
___1200___1400___1600 |
$ 20 |
________/$______ |
| 10. RINGLING TOUR |
___1300___1400___1500___1600 |
$ 12 |
________/$______ |
| 11. SELBY GARDENS |
___1300___1400___1500___1600 |
$ 8 |
________/$______ |
| 12. MOTE MARINE |
___1300___1400___1500___1600 |
$ 8 |
________/$______ |
SOUVENIR
CONVENTION SHIRT (high quality, polo,
ready on arrival)
For mailing to your address above please add $5 per
shirt.
| Women: __S__M__L__XL |
Men: __S__M__L__XL
|
$ 30 |
________/$______ |
|
|
|
|
| |
|
| |
|
GRAND TOTAL |
$_______ |
DEADLINE 20 APRIL 2003
MAIL CHECKS PAYABLE TO:
FCOC CONVENTION 2003 P.O. BOX 174 PARRISH, FL 34219
CALL FOR YOUR HYATT HOTEL RESERVATIONS
800 233-1234 /
941 953-1234
ASK FOR
FLORIDA COUNCIL OF CHAPTERS SPECIAL RATE
$115 (single
or double)
