Event Sign-Up Form

  Please send in your reservation form to arrive NLT Friday, 19 February 2016

Call Wes Fong at 595-6127 or 220-5266, if necessary, for more information
This form is for the

Member, Spouse Name Tags:

(Separate names with commas)

Guest Name Tags:

(Separate names with commas)

Cost = $20.00 per person   Guests are most welcome  
 Number attending @ $20 each:

Phone number: 

   
Email:  

Luncheon Total $

Donations Greatly Appreciated:  Scholarship  $ 

Community Services $ 

Luncheon + Donation Total: $    Do you need a ride?  

Members are encouraged to car pool and offer rides to those who may not be able to drive.

There are two ways to pay, Check or Credit Card. Indicate your payment Method:

  

By Check:  Provide any comments and press the Submit button below.  Mail your check to: 

Hawaii Aloha Chapter, MOAA, P.O. Box 201441, Honolulu, HI 96820, with a memo note on the check stating what it is for.  
With a Credit Card:  Remember the total amount you are paying.   Provide any comments and press the Submit button below.  You will be taken to a page where you will make your payment.

Call Wes Fong at 595-6127 or 220-5266, if necessary, for more information

Comments or Information Request:

  (Please be patient - Do not press on

  the Submit Button more than once)