HMM 162

Reunion 2004 Registration Form

July 8 -11, 2004 Reno NV

Name: ___________________________________________________

Address: ____________________________________________________

City: _____________________________State: ___________Zip: _______

Telephone#:_______________Email Address: _______________________

Nick Name__________________WifeÕs Name_______________________

Names of Additional Guest Attending_______________________________

What Date Will You Arrive for the Reunion: ________________________

What Years Did You Serve With HMM 162: _________________________

Registration Fee (Hooch Fee):

The HMM 162 registration or hooch fee is $75 per person.  Which covers the hooch expenses (food snacks, beverages etc.), the HMM 162 mini-reunion dinner buffet on Friday July 9, 2004.

Number of People attending: _______ X Registration Fee at $75 per person. (See Above)

Total Amount of Registration Fees $________________________

MAKE ALL CHECKS PAYABLE TO: HMM 162 ALUMNI FUND

Note at the bottom of your check that this is for reunion registration
Please print this form, fill it out and mail it along with your payment to:

Jim Carroll
HMM 162 Alumni Fund
209 Farmdale Road West
Hopkins, MN 55343-7186