State Online Registration

The Next State Association Annual Convention is scheduled for the Weekend: See Below for More Information...

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~ ONLINE RESERVATION FORM ~

~ STATE ASSOCIATION ANNUAL CONVENTION in ... ~
HOST LODGE:

~ WISP RESORT RESERVATION FORM:

** WISP RESORT ADDRESS: 296 Marsh Hill Road, McHenry, MD and phone is 301-859-3159.

** HOTEL RESERVATION DEADLINE = MAY 9th ~~~ ** MEALS ONLY DEADLINE = MAY 9th
( OUR BLOCK of ROOMS WILL BE RELEASED AFTER MAY 9th )

~ CHOOSE A PACKAGE & COMPLETE THE REMAINING FORM. THEN CLICK ON SUBMIT TO CON-CON, AT BOTTOM OF FORM...
( this form will then be sent electronically [by Email] to Con-Con )

*** NOTE: ...at the bottom of all the Packages there will be a "Total $$$ DUE" box - this MUST have a figure in that box - if NO $$$ DUE, then place a 0 in that box.

* A Red asterisk signifies that that box must be completed before Form will be Submitted. If the box calls for just a number and no number applies, then place a zero in that box.

Choose: *

PACKAGE 1:

PACKAGE 1: includes Hotel Room for two [2] Nights on June 9th and 10th, Breakfast Buffet for Saturday & Sunday, Saturday Night - All-American Dinner Buffet & Awards.

~ Single [1] Occupancy = $325.00 // Double [2] Occupancy = $416.00
~ Triple [3] Occupancy = $531.00 // Quad [4] Occupancy = $624.00

Select One *

Single Occupancy Only: *

All Other Occupancy (2/3/4): *

* Indicates required field

TOTAL $$$ DUE: *

PACKAGE 2: *

INDIVIDUAL ROOM ONLY:

CHOOSE ONE: *

Which Night: *

TOTAL $$$ DUE: *

PACKAGE 3: *

Breakfast ONLY @ $18.50 per Day / per Person

Which Day: *

How Many Person(s): *

TOTAL $$$ DUE: *

PACKAGE 4: *

DINNER ONLY @ $40.00 PERSON

HOW MANY: *

TOTAL $$$ DUE: *

~ THEME FOR SATURDAY NIGHT DINNER (w/Entertainment): is "TEAM - WEAR YOUR FAV JERSEY".

( Advanced Reservations Only - No Tickets will be Sold at the Door )

Registration Fee: *

$5.00 per Person Attending

How Many Attending: *

Total Reg Fee Due: *

~ REGISTRATION FEE IS PER ATTENDEE IN ADVANCE OR AT THE DOOR = # x $5.00 $______.00

*** TOTAL AMOUNT DUE FROM ALL PACKAGES & OPTIONS SELECTED ABOVE =
(INCLUDING all $5.00 REGISTRATION FEE ABOVE // PER PERSON)
*** NOTE: all Package "Total $$$ DUE" box MUST have a figure in that box - if NO $$$ DUE, then place a 0 in that box.

~ TOTAL AMOUNT DUE BASED UPON OPTIONS 1, 2, 3, 4 and 5 REGISTRATION =

TOTAL $$$ DUE: *

* A Red asterisk signifies that that box must be completed before Form will be Submitted. If the box calls for just a number and no number applies, then place a zero in that box.

Name *

First

Last

Spouse / Roommate(s): *

Lodge Name & No: *

Roommate(s): *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Badge #1: *

Badge #2: *

Badge #3: *

Badge #4: *

Comments or Requests: *

SUBMIT RESERVATION to CON-CON

*** SEND PAYMENT BY CHECK - MADE PAYABLE TO: MD/DE/DC ELKS ASSOCIATION.
** SEND TO: JOHN & MERRILYN RAMSEY, 152 HICKORY RIDGE ROAD, SMYRNA, DE 19977
* Payment expected within 5 days of Submitting above Form to maintain Reservation. Must be before Deadlines listed above...

*** ANY QUESTIONS OR SPECIAL NEEDS, CALL: JOHN @ (302) 242-1117 OR MERRILYN @ (302) 382-0288 // or HOME: (302) 659 - 0659.

2017-01_gl_blouse_order_form.pdf
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