NEWARK VALLEY NY ENCAMPMENT WEEKEND REGISTRATION FORM
Registration Fee is $15 Includes Event, Meal and Raffle
LAST NAME______________________________ FIRST____________________UNIT____________________________
ADRESS_____________________________________________________________________________________________
PHONE NUMBER___________________________E-MAIL ADRESS____________________________________________
IMPRESSION.. ( ) AMERICAN ( )GERMAN ( ) BRITISH ( ) ITALIAN ( ) OTHER__________________________
PLEASE MAKE CHECKS PAYABLE TO: STEVEN SLOMA
MAIL PAYMENTS TO: 143 KRAGER RD BINGHAMTON NY 13904
QUESTIONS?
SEND INQUIRIES TO STEVE AT
