THE AVERY MEMORIAL ASSOCIATION 2011 REUNION REGISTRATION FROM

THE AVERY MEMORIAL ASSOCIATION

ANNUAL MEETING RESERVATION FORM
SATURDAY JULY 14, 2012

Name(s)______
Address:
Phone Number: (_) _
Guest(s):
Children’s Names:________
The Annual Meeting of the Avery Memorial Association will be held Saturday July 14, 2012 at the Groton Inn & Suites, 99 Gold Star Highway, Route 184, Groton, CT from 10 am to 3 pm.
Save money by registering early!

(# of attendees) Attending at $25 each, received by June 14, 2012.......$ _
(# of attendees) Attending at $30 each, received after June 14, 2012....$ ____
(# of attendees) Children 6 yrs. and under .......................................$ _FREE
(# of renewals) Annual Dues (7/1/12 - 6/30/13) at $25 each.............$
(# of renewals) Annual Family (Household) Dues at $35 each........$ __
(# of people) _ Life Membership at $500 each...................................$ ____
Tax-deductible Contribution..........................................................................$ _
Total Enclosed..................................................................................................$ _______
Is this your first time at the Annual Meeting? [_] Yes [_] No
Do you have E-Mail? E-Mail Address: ___________________________________________
Please make check payable to the “Avery Memorial Association,” and send your check with this completed form (or a copy) to: Avery Memorial Association P.O. Box 7245 Groton,CT 06340-7245
Refund Policy: 100% refund if we are notified before June 1, 2012 50% if we are notified in June, 2012 No refund in July 2012 or “no show”
Anyone registering "at the door" (why would you?) will NOT receive a registration package a.k.a. "goodie bag."