GRAND LODGE REGISTRATION FORM
"DOES FROM A DISTANCE" June 17 - 21, 2012 Hostess Drove: Riverton Drove #48, Wyoming
GRAND LODGE COMMITTEE CHAIRMEN
Chairman: Frances Case (307) 856-2455 frazzelbutt@yahoo.com
Co-Chair: Virgina King (307) 856-2104 vaking@bresnan.net
Co-Chair: Hollie Watterson (307) 851-0996 hwatterson@hotmail.com
Treasurer: Marie Wilson (307) 856-0396 swilson@wyoming.com
Secretary: Suzette Erhart (307) 856-7425 weekend@wyoming.com
Registration: Wyola Tait    
MEMBER REGISTRATION INFORMATION
First Name Last Name
Address1 Address2
City State
Zip Zip +
Phone E-Mail
DROVE INFORMATION
Drove Drove Number Drove State
 
Tour Registration Form   -   Cutoff Date:  May 7, 2012
M.S. Dixie II Sunset Dinner Dance Cruise
Friday, June 15, 2012 4:15 pm - 11:00 pm (min 40) Quantity: $each Total $
Virginia City Tour with Lunch
Saturday, June 16, 2012 9:00 am - 3:00 pm (min 40) Quantity: $each Total $
Tours will be conducted only if the minimum registration is met. No refunds will be issued unless the tour is cancelled.

Total Due For All Tours $

Activities Registration Form   -   Cutoff Date:  May 7, 2012
"Jewel Of The West" Reno Elks Lodge #597, Nevada
Barbeque & music, Includes transportation to the Lodge
Saturday, June 16, 2012 5:00 pm - 11:00 pm Quantity: $each Total $
"Cowgirl Up" Fun Night Banquet (dress western)
BBQ Chicken & Pork, Oven roasted potatoes, Corn, Biscuit & Apple Pie
Monday, June 18, 2012
   Quantity: $each Total $
"Hope Lights The Way" Formal Banquet
 
Tuesday, June 19, 2012   Quantity:  Fresh Filet of Salmon $each Total $
    Quantity:  Entrecote of Beef $each Total $
"All Decked Out" Luncheon
 
Delegates, Five-Year Officers, Past Presidents (First Time)
 
Wednesday, June 20, 2012   Quantity:  Grilled Herbal Chicken Breast $each Total $
    Quantity:  Marinated Sliced Beef $each Total $
 
All Other Does
 
    Quantity:  Grilled Herbal Chicken Breast $each Total $
    Quantity:  Marinated Sliced Beef $each Total $
"H.H. Membership"
Wednesday, June 20, 2012 Current Member    ($2 at the door) Quantity:  (Current Member) $each Total $
Wednesday, June 20, 2012 H.H. Initiate Quantity:  (Initiate) $each Total $

Total Due For All Activities $

TOTAL AMOUNT DUE FOR TOURS & ACTIVITIES

Total Due For All Tours & Activities $

Please remit one (1) check for all selections made
Make checks payable to "2012 Grand Lodge Convention" (Your check is your receipt)
Mail Form and Check to:
Wyola Tait, Registration Chairman, 3922 Tam-O-Shanter Drive, Riverton, WY 82501
CONVENTION HEADQUARTERS:  -   Cutoff Date:  May 12, 2012

John Ascuga's Nugget, Sparks, NV 89432-0797 Phone: 800-648-1177

  

ROOM RESERVATION FORM
(In order to get the negoiated rates for the convention, you MUST mention "BPO Does" at time of reservation)
ARRIVAL DATE: DEPARTURE DATE: NUMBER OF NIGHTS REQUIRED:
Lodging Rates:   -     plus applicable city and state tax
Group Name: "BPO DOES"     (Non Smoking and Handicap accessible subject to availability)
First night's lodging MUST accompany reservation form. If providing a credit card,
it will be charged at the time the reservation is confirmed.

Submit ONLY ONE form per room.
Credit Card Information must be written in on the printed form, we do not collect this information on-line.
After you have filled in the information above, the below button will format the page to a printer friendly format.
The information that you entered is NOT saved and will be deleted when you navigate away from this page.