2020 Registration Form

Brothers………………

If you are a AMD member in good standing and wish to be included on a email list please leave your contact information on the Contact Page or email me at amd.ca@icloud.com.  

If you have trouble printing this form please contact me and I will either mail, email or make other arrangements for your registration.  

November 14, 2020                                                                                                                        

Taft-Midway Lodge, 521 North Street, Taft, CA 93268

2020 Ingathering Registration Form

Brothers………………

Name (As you want to appear on certificate):

Please Print: __________________________________________________________

Mailing Address: _______________________________________________________

Phone: ____________________ Email: _____________________________________

Council Name and Number: _______________________________________________

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Registration: ………………………………………………….……………..….……….. $3.00

The Ark and Dove ……………………………………………………………….$15.    ________

 

Installed Commander Noah …………………………….………………………$15     _________

(Chair Degree for Present and Past Sovereign Masters)

 

Festive Board Feast …………………..…………………………….…………..$50        _______

Ye Ancient Order of Corks (Available with Festive Board RSVP ) …....……$20        _______

  On site Registration Mailing Fee: ……………………………………….… $ 2.00      _______

                                                                                     Total …………………..……$_______

Check:______No. ______ Cash: _______ CC: ________

Please mail form and payment to:

Western Council No. 41 AMD

P. O. Box 9423

Bakersfield, CA 93389

 


© Gary Jackson MacPro 2011