Event Sign-Up Form

Emergency Management Agency (EMA) Tour

at the Civil Defense Center, Diamond Head

and / or Buffet Lunch at Jose's Mexican Restaurant

May 26, 2016

  Please send in your reservation form by Friday, May 20.

 The tour inside the Diamond Head EMA Facility can accommodate only 44 people.

 
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 for the Buffet Lunch at Jose's Mexican Restaurant

The Emergency Management Agency (EMA) Tour is free.

You may attend either one or both.  Guests are most welcome  
 Number attending Lunch Buffet@ $20 each:

Phone number: 

   
 Number attending the EMA Tour:                   

  

    
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 the check 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 Mark Torreano at 343-4877, if necessary, for more information

Comments or Information Request:

  (Please be patient - Do not press on

  the Submit Button more than once)