April 2nd through April 4th, 2009
St. Louis Airport Marriott Hotel Register
Mid-Winter Meeting PRE-REGISTRATION FormC.S.A.S.M.C.
Mr. Brad Waite - Secretary/Treasurer
926 South 41st Street
Omaha, NE 68105
(402) 346-6211 or FAX: (402) 346-9509 |
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C.S.A.S.M.C. MEMBER or NON-Member
(Circle, choose one)
My Name__________________________________
Unit Name__________________________________
Shriners (Temple)____________________________
C.S.A.S.M.C. Voting Rep._____________________
Address_____________________
City_________________________
State________________________
Zip_________________________
Telephone____________________
email address_________________
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