GEORGIA MOOSE ASSOCIATION 2010 STATE CONVENTION

SATURDAY NIGHT LUAU BANQUET

REGISTRATION FOR ATTENDANCE:  09 / 25 / 2009   6:30 PM

NAME: ________________________________________

SPOUSE/GUEST:  _________________________________

COST PER PERSON: $ 25.00 DISCOUNT QUALIFICATION BELOW

MEMBERSHIP DISCOUNT: SIGNED 5 MEMBERS YOUR COST IS $20.00 PER PERSON

                                                   SIGNED 15 MEMBERS YOUR COST IS $10.00 PER PERSON

                                                   SIGNED 25 MEMBERS YOUR COST IS $0 (FREE) PER PERSON

ALL MEMBERS MUST BE SIGNED AND RECORDED IN THE PERIOD OF  5/01/09—4/30/2010

AGENDA:  LUAU AT POOL, AWARDS, RECOGNITION AND MUSIC TO FOLLOW

REMIT: GEORGIA MOOSE ASSOC. 62 HONEY LANE McDONOUGH, GA 30252

CUT OFF DATE IS SEPTEMBER,7^TH  NO MORE TICKETS WILL BE SOLD