Registration Form
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Registration Form for 2nd RSM Reunion 2010 in Dayton, Ohio
Please fill out and return to:
John Puterbaugh
79 S. Spring St.
West Milton, OH 45383
Phone: 937-698-0763
Email:
Folkjohn@aol.com
My name is
______________________________________________________________
Address
_________________________________________________________________
City, State,
Zip____________________________________________________________
Email
___________________________________________________________________
Telephone number(s)
_______________________________________________________
( ) Yes, put me down for the Dayton, OH Reunion on April 26th
through April 29th, 2010.
There will be ______ people attending, including myself.
The full names of the others attending with me are (required for name
tags):
________________________________________________________________________
________________________________________________________________________
(Please make checks payable to John Puterbaugh)
Enclosed is my reservation fee of $150.00 per person
......................................$_____________
Also enclosed is my contribution for mailing expenses (suggested: $10)
........$_____________
Total amount enclosed
............................................................................................$_____________
All of us plan on attending the following events (sorry, no discount for
not attending the events):
( ) Cocktail party Monday
( ) Cocktail party
Tuesday (
) Dinner Wednesday
( ) Group Photo
( ) Add my name to the volunteer
list. I will be willing to
help at the:
( ) Registration
(
) Hospitality Suite
( ) Wherever Needed
( ) I’m not sure if I can make the reunion, but it sounds
enticing! Keep me on the
mailing list. |