Page 20 - MFM April 2012
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GRAND LODGE AF & AM of MONTANA
                                             PRE-REGISTRATION

                         146th Annual Communication, June 21, 22, & 23, 2012
                         Crowne Plaza Hotel, 27 N 27th Street, Billings, Montana

                              Mail this Form to
                       146th Grand Communication

                                 PO Box 1158
                          Helena, MT 59624-1158

Registration must be Received prior to June 1, 2012                                                    General Member Registration Form

PLEASE TYPE OR PRINT (Name Badge Will Be Completed From This Information)

NAME:________________________________________________________________________________________
                                                            (Full Given Name)

TITLE: ________________________________________________________________________________________

NAME OF LODGE: _________________________________________________ LODGE NO.: __________

MAILING ADDRESS:____________________________________________________________________________

CITY:_______________________STATE:____________ZIP:_____________TELEPHONE:__________________

ACCOMPANIED BY (Ladies name):_______________________________ E-MAIL:_______________________

Please complete the top section and mail it in even if you do not plan to purchase any meals.

                       Tickets are limited and availability is not guaranteed after June 1st

Friday, June 22, 2012

Men’s Luncheon (Italian Sandwich/Fruit/Dessert)      No.____ @ $17.00 = $_________

Ladies Luncheon/Tour (Chicken Chef Salad/Dessert)    No.____ @ $17.00 = $_________

Master Masons (& Ladies) Banquet

                       (Prime Rib)                   No.____ @ $35.00 = $_________

                       (Chicken Oscar)               No.____ @ $35.00 = $_________

                       (Vegetarian)                  No.____ @ $35.00 = $_________

Saturday, June 23, 2012

Breakfast (Men & Ladies) (Breakfast Buffet)          No.____ @ $17.00 = $_________

Men’s & PGM’s Luncheon (Turkey Bacon Club/Dessert)   No.____ @ $17.00 = $_________

Reception for New Grand Master & Grand Lodge Officers No.____ @ $25.00 = $_________

                         (Light Buffet, Beer Bar)

                                                 Total Activity Amount:  $:__________________

Payment for Activities:              (Please make checks payable to: 146th Annual Communication)
Check Enclosed#_________

Credit Card (Master Card or Visa Only):___________________________________________ Expires:__________

SIGNATURE:_____________________________________________________________

Registration/Credentials and Session will be at the Crowne Plaza, 3rd Floor
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