This is the registration form for the Saturday, 14 November 2009, First Annual Holiday Celebration of the Southern Maryland Chapter of the Military Officers Association of America (MOAA) in the new banquet room at Lenny's Restaurant in California, MD.   

Please note:  As stated in our charter, these meetings are for MOAA members and their guests.

Reservations must be made and paid by close of business Saturday November 7th.  If paid later, the cost will be increased as indicated below.  

Here is my registration information (and dues payment, if required) 

First name
Last name
Active Duty: Organization
Active Duty Only: Rank
Active Duty: Duty Title
Name Tag Should Read
Work Phone
E-mail

    My membership status in MOAA is (select one please):

     MOAA SOMD Member (paying 2009 dues of $20.00 with this transaction)
     MOAA SOMD Member (dues have been Paid for 2009)

    Please select one of the following.

    Beef

    Salmon

     Served with Salad, Roll & Butter and Beverage.

    Please select the applicable column and total the amount you owe:

 *If you are paying in advance (no later than Saturday 7 November), pay the indicated amount.

 RESERVATIONS SHOULD BE MADE AND PAID NO LATER THAN Saturday, 7 November.

 

Items Paid 2009 Member Paying 2009 Dues Now

Beef

*$30.00

*$30.00
Salmon *$30.00 *$30.00

MOAA SOMD Dues 2009 ($20)

Paid

Total Cost (pls. sum to total by typing over)

 $ $
Questions about the luncheon?  Call Tom Smith at (301) 475-3694(H)
Address or Directory Changes?  Send to SECRETARY

 

By submitting this form, you are committing to pay the amount indicated above.

I will mail a check, payable to Southern Maryland MOAA, for the total amount indicated above to:

Southern Maryland MOAA

P.O. Box 84, 

Patuxent River, MD 20670
 

Thank you for making your reservation. Look forward to seeing you on Saturday, 7 November.

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