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

Domenic Iammarino -- 2641 Doug Avenue -- Hudson, OH -- 44236-3206

          YES!, I/we plan to attend the reunion!                   RANK/RATE:  

FIRST NAME:   LAST NAME:   YEARS ON BANG:   TO 

ADDRESS:     PHONE:  ()  

CITY:   ST:  ZIP: 

SPOUSE'S/GUEST'S NAME(S):  

ARRIVAL DATE: DEPARTURE DATE:   E-MAIL:  

NUMBER ATTENDING USS COD AND ROCK AND ROLL HALL OF FAME TOUR:   012345 678   @ $35 per person.

NUMBER ATTENDING DINNER IN "LITTLE ITALY": 012345 678  @ $5 per person (BUS RIDE ONLY.  DINNER $25 PP + ALCOHOL, TAX & TIP.  PAY AT RESTAURANT.).

NUMBER ATTENDING NFL HALL OF FAME AND/OR NATIONAL FIRST LADIES MUSEUM TOUR:       012345 678   @ $45 per person.

SPECIFY CHOICE:   NFL HALL OF FAME   012345 678   FIRST LADIES HALL OF FAME   Now Sold Out.      BOTH (LIMITED TO FIRST 15 SIGNUPS RECEIVED)   Now Sold Out  

NUMBER ATTENDING BANQUET:                                                                012345 678   @ $50 per person.

SPECIAL DIETARY NEEDS:  

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

MAKE CHECK PAYABLE TO:  DOMENIC IAMMARINO TOTAL:   $ 

MUST BE IN BY AUGUST 15TH

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