------------------------------Complete form, print and mail to:------------------------------

Len Scuito -- PO Box 477 -- Spofford, NH -- 03462-0477

          YES!, I/we plan to attend the reunion!

FIRST NAME:   LAST NAME:   YEARS ON BANG:   TO  RANK/RATE:  

ADDRESS:     PHONE:  ()     E-MAIL:  

CITY:   ST:  ZIP:  ARRIVAL DATE: DEPARTURE DATE:

SPOUSE'S/GUEST'S NAME(S):  

NUMBER ATTENDING USS CONSTITUTION AND SAMUEL ADAMS BREWERY TOUR:   012345 678   @ $XX per person.

NUMBER ATTENDING JFK LIBRARY AND FANEUIL HALL MARKETPLACE TOUR:                          012345 678   @ $XX per person.

NUMBER ATTENDING BANQUET:        012345 678   @ $XX per person.

DINNER CHOICES:  Lasagna with Meatballs   012345 678    Seared Pork Loin    012345 678     Seared Salmon    012345 678

SPECIAL DIETARY NEEDS:  

HOSPITALITY ROOM STIPEND PER PERSON:                    21345 678 @ $10 per person.

MAKE CHECK PAYABLE TO Len Scuito TOTAL:  $                     

MUST BE IN BY June 10TH

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