| OFFICIAL CONVENTION PRE-REGISTRATION
A registration fee of $15.00 for each person attending, whether a delegate,
alternate or a guest, must accompany this form. Make your check payable to "DEPARTMENT CONVENTION." No credit cards will be accepted. Please mail this form with your check to:
Attention: Curt Markert, 2011 Department Convention, P.O. Box 34, Mahnomen, MN 56557. Registration after June 17th will be $18.00.
Legion ________________ SAL_________________ Auxiliary_______________
District # ____________ Post/Squad/Unit # ______________________________
Name____________________________________________________________
Address___________________________________________________________
City _______________________________ State ________ Zip ______________
Delegate ______ Alternate ______ Guest_________
Delegate at-Large (Auxiliary) ______________________________
(As a Past Department President or member of the Department Executive Committee)
(Please check one of the above)
If additional preregistrations accompany this request, this preregistration form should be photo copied for each person. The $15.00 registration fee must be enclosed for each person.
Please do not use this registration blank for more than one person.
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