Registration Form for 2010 USS COLLETT DD730 Reunion.
San Diego, CA   September 29 through October 3 2010

Name:     _____________________________________________________

Address:  _____________________________________________________

City:     ______________________  State: ___  Zip: ____________


Name for Badge:  ______________________________________________

     Companion:  ______________________________________________

        Guests:  ______________________________________________

                 ______________________________________________
 
                 ______________________________________________


List any special dietary needs:

_______________________________________________________________

_______________________________________________________________

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Thursday  (City Tour)
              $30.00  Number attending __  Subtotal ___________
Friday    (USS Midway & Harbor Excursion)
              $55.00  Number attending __  Subtotal ___________
Saturday  (Point Loma in AM)
              $30.00  Number attending __  Subtotal ___________

Banquet       $40.00  Number attending __  Subtotal ___________

Registration  $15.00                                   $15.00        

Unpaid Dues   $10.00                       Subtotal ___________

Future Dues   $10.00  Years _____________  Subtotal ___________

                                              Total ___________

Make checks payable to:  USS COLLETT Association

Mail to:
                    Sue Senn
                    P.O. Box 742
                    Pearce, Arizona, 85625

PLEASE RETURN FORM AND PAYMENT NO LATER THAN 29 AUGUST 2010