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GEORGIA MOOSE ASSOCIATION MID YEAR CONFERENCE PRE- REGISTRATION FORM February 23-26, 2012 NAME_______________________ LODGE NAME AND #__________________ MID #________________ EXPIRITION DATE__________________ PILGRIM_______ ADMINISTRATOR_______ FELLOW________ GOVERNOR __________ M/ LEGIONAIRE____ PAST GOVERNOR ___________ REGISTRATION FEE $10.00 (IF DESIRED) FELLOWSHIP LUNCH $15.00 TOTALS PAID CK# ________ $__________ REMIT CHECK OR MONEY ORDER TO: Georgia Moose Association Inc. 62 Honey Lane Mc Donough Ga 30252 Pre-registration accepted until February 15th 2011 after which fee is $15.00 Hotel reservations can be made by calling 1 800-callaway (1-800-225-5292) ASK FOR THE MOOSE RATE OF $79.95 REGISTRATION ACCEPTED NOW |