Hagerstown, MD class of 1953
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*REGISTRATION INFORMATION
HHS In Florida Electronic Registration Form If you type in this form to submit it electronically, you'll need to place your cursor at the end of each line in which you wish to type, backspace to erase the line and then begin typing. Note that you need to scroll down in this immediate section to display the entire form. I'll admit this is not the easiest thing to work with. (If you want to print out this form to mail it, note that different computer programs will do different things with the form. You may need to experiment and make sure you print it out in sections. It should take three different printings for most people. THERE IS A PRINTABLE FORM ON ANOTHER PAGE WHICH IS BETTER TO USE FOR THIS PURPOSE.) Note that once you hit "Submit" AT THE BOTTOM OF THIS PAGE, it is gone - directly to M.F., so make sure you've completed everything before you do that. AND NOTE THAT AN ELECTRONIC REGISTRATION IS NOT COMPLETE UNTIL A CHECK IS RECEIVED FOR ALL ITEMS BY M.F. THIS FORM ONLY GETS YOUR NAME AND INFO ON HIS BOOKS EARLIER. For questions or additional information Phone: 407-831-2928 PLEASE PRINT NAMES AS YOU WANT THEM TO APPEAR ON YOUR NAME TAG Name ______________________________________________School_________________________ Year______ Name __________________________________________School_______________________________Year_______ (Lady Graduates, Please Include Your Maiden Name) (Include HS although not Hagerstown) Home Street/P.O._______________________________City____________________________State____Zip________ Home Phone__________________________________ Email Address______________________________________ Cell Phone____________________________________ Other Phone_______________________________________ Temporary Florida address, if applicable: Dates (From) ____________________ (To) ______________________ Address______________________________________City____________________________State____Zip______ Florida Phone Number ___________________________Florida Cell _____________________________________ PLEASE INDICATE PERSONS ATTENDING EACH FUNCTION LISTED BELOW FRIDAY JANUARY 22, 2010 5TH Annual HHS Golf Scramble (Men & Women Encouraged to Participate) Name __________________________ Name _________________________ $30.00 per player $___________ HHS Fla. State Park Tour with Pancake Breakfast Name __________________________ Name _________________________ Pay day of event __ check for Boat Tour HHS 50’s/60’s Sock Hop & Dinner Name __________________________ Name _________________________ $22.50 per person $___________ (Includes Tax & Tip) SATURDAY JANUARY 23, 2010 5th Annual HHS Florida Luncheon Name __________________________ Name _________________________ $23.50 per person $___________ (Includes Tax & Tip) Select entree: Roast Beef ______ Chicken ______ (Indicate by number) SUNDAY January 24, 2010 HHS Farewell Sunday Brunch Name __________________________ Name _________________________ $15.00 per person $___________ (Includes Tax & Tip) (Add up cost of each activity you selected) TOTAL $___________ Complete your registration, submit it or mail it and your check made out to M. F. Kershner to cover all activities selected. Be sure to keep a copy of this information for yourself Mailing address: M. F. Kershner HHS FL 2010 305 Nelson Avenue Longwood, FL 32750-6733
*Please record here names, as you want them to appear on nametags
leave a note with your registration:
Please make all choices necessary before submitting. Note that your submitted registration for these events will not be valid until your check is received by M.F. Kershner.