------------------------------Complete form, print and mail to:------------------------------
Isaac Cohen------137 Fairview Avenue------High Bridge, New Jersey------08829-1214
YES! I/we plan to attend the reunion! RANK/RATE:
FIRST NAME: LAST NAME: YEARS ON BANG: TO
ADDRESS: CELL PHONE: () IMPORTANT IF YOU ARE USING THE SHIPMATE SHUTTLE!
CITY: ST: ZIP: E-MAIL:
SPOUSE'S/GUEST'S NAME(S):
ARRIVAL DATE: ARRIVAL TIME AND FLIGHT NUMBER: DEPARTURE DATE: DEPARTURE TIME AND FLIGHT NUMBER:
NUMBER REQUESTING THE SHIPMATE SHUTTLE: 012345 678 FREE!
NUMBER ATTENDNG PHILADELPHIA CITY TOUR: 012345 678 @ $50 PER PERSON. TOTAL COST
LUNCHEON CHOICES (INCLUDED): PHILLY CHEESESTEAK 012345 678 HAMBURGER 012345 678 CHEESEBURGER 012345 678 BUFFET 012345 678
NUMBER ATTENDING BECUNA, OLYMPIA AND NEW JERSEY TOUR: 012345 678 @ $75 PER PERSON. TOTAL COST
NUMBER ATTENDNG QVC TOUR: 012345 678 @ $10 PER PERSON. TOTAL COST
NUMBER ATTENDING BANQUET: 012345 678 @ $60 PER PERSON
DINNER CHOICES:PENNE PRIMAVERA: WITH MARINARA SAUCE: 012345 678 WITH MUSHROOM CREAM SAUCE 012345 678 NEW YORK STRIP STEAK WITH ROASTED ONION, LEMON HERB NEW POTATOES AND GREEN BEANS 012345 678 HONEY BBQ SALMON FILET WITH RICE AND VEGGIES 012345 678
SPECIAL DIETARY NEEDS:
HOSPITALITY ROOM STIPEND PER PERSON: 21345 678 @ $20 PER ADULT.
MAKE CHECK PAYABLE TO: Isaac Cohen TOTAL: $
MUST BE IN BY SEPTEMBER 4TH
GENERAL QUESTIONNAIRE - WHAT WOULD YOU LIKE TO SEE IN THE HOSPITALITY ROOM?:
Note: print this form in "landscape" layout rather than "portrait".
Return to Schedule of Events Page Return to Hotel Page