FLORIDA SHRINE ASSOCIATION
1999 CONVENTION REGISTRATION FORM
MAY 5 – 8, 1999
Sarasota, Florida
Temple: ______________________ Location: ________________________
Hotel - Motel Assigned: _________________________ Rate: _________
ROOM DEPOSIT FOR FIRST NIGHT PLUS $10.00 REGISTRATION
MUST ACCOMPANY APPLICATION
Last Name: ____________________ First Name: ______________ MI: __
Address: ________________________________________________________
Street: _________________________________________________________
City: _______________________________ State: __ ZIP: ____________
Telephone: _____________________ Email: _________________________
If Two or More Sharing, Fill In All Names:
1. ______________________________________________________________
2. ______________________________________________________________
3. ______________________________________________________________
Room Preference: King ___ 2 Doubles ___ Smoking: Yes __ No __
Arrival Date: ________ Departure Date: _________ Total Nights: __
In Case Of Emergency:
Contact: _______________________ Phone No: ______________________
Unit or Title: _________________ Parade: Y _ N _ Compete: Y _ N _
Other Comments: _________________________________________________
Make all checks payable to your home Temple
This form should be given to your temple's Recorder or Housing
Chairman along with your deposit and registration, they will send
it no later than March 1, 1999, to:
Morton Steiger, Housing Chairman
2534 Waterview Court
Sarasota, FL 34231
Questions? Call Convention Housing Chairman Mort Steiger
Phone: (941) 925-4408
Email: morger2@home.com
Web: http://www.trowel.com/fsa99
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Below for Sahib Temple Use Only
Date Received: ___________ Check No: ___________ Cash: __________