Nineteenth Annual Reunion
Philadelphia, Pennsylvania
September 24 - 28, 2009
at
Couryard by Marriott

Please complete this form and return it with your check to
Walter Sutter, Treas.
6385 Wager Dr.
Rome, NY 13440

Please make check out to Walter Sutter, Treas. not the Panamint.
Send registration form and money by August 1, 2009.

Members Name__________________________________
Address________________________________________
________________________________________
________________________________________

Phone Number___________________________________

Spouse/Guest Name_______________________________

Total Number registered________ x $213.66 = $_________

Banquet Saturday night          you          spouse/guest
   1. Salmon                          (       )        (                   )
   2. Chicken                         (       )        (                   )
   3. Steak                             (       )         (                  )

                                                             Please write name