May 15-17, 2009 OA Weekend Registration

*** Kittatinny Lodge Member Registration Form ***
*** Please Print Clearly - Check if your dues are paid before registering ***

Name: ____________________________________________

Lodge Member ID#: _____ _____ _____ _____

Phone: ( ______ ) ______ - ______________

Ordeal members with 10 months in the lodge are eligible for Brotherhood testing. Check the appropriate fee and indicate the Total amount included.  Please use one form per each member. Forms must be received in office on or before indicated date. Additional forms may be obtained at the council office or the Kittatinny Web Site. Thank you.

FEES: 

[    ] $20.00 - Late Fee (Received after May 1, 2009)

[    ] $15.00 - Regular Fee (Received before May 1, 2009)

[    ] $10.00 - Partial Weekend - 2 meals (Received before May 1, 2009)

[    ] $16.00 - Additional Brotherhood Testing Fee  *ONLY* for eligible Ordeal Members

TOTAL ENCLOSED $_______________

Mail fee, envelope, and completed form to:
Kittatinny Lodge 5, Hawk Mountain Council, BSA
5027 Pottsville Pike, Reading, PA 19605

Last Update: 07/30/2008