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2024 Brotherhood Of Men Registration Form
Please complete this form to register and order memorabilia.
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REGISTRATION TYPE?
*
3 MEN FOR 135 EACH SPECIAL--DEADLINE, SATURDAY, AUGUST 31ST, 2024
REGULAR - $165 PER PERSON - DEADLINE DATE: Thursday, October 10, 2024
LATE - $185 PER PERSON - DEADLINE: FRIDAY, OCTOBER 18TH - Friday, October 25, 2024
Required
ATTENDEE #1--SPONSOR (ONE CREDIT CARD FOR ALL CHARGES)
FIRST NAME
*
Your answer
LAST NAME
*
Your answer
CITY
*
Your answer
STATE
*
Your answer
EMAIL ADDRESS
*
Your answer
CHURCH AFFILIATION
*
Your answer
CELL PHONE
*
Your answer
ATTENDEE #2 - FIRST NAME
Your answer
LAST NAME
Your answer
CITY
Your answer
STATE
Your answer
EMAIL ADDRESS
Your answer
CHURCH AFFILIATION
Your answer
CELL PHONE
Your answer
ATTENDEE #3 - FIRST NAME
Your answer
LAST NAME
Your answer
CITY
Your answer
STATE
Your answer
EMAIL ADDRESS
Your answer
CHURCH AFFILIATION
Your answer
CELL PHONE
Your answer
Polo Shirt
Small - $32, QTY ____
Medium - $32, QTY ____
Large - $32, QTY ____
XL/1XL - $35, QTY ____
2X - $38, QTY ____
3X - $41, QTY ____
4X - $44, QTY ____
5X - $47, QTY ____
6X - $50, QTY ____
Total Polo Shirts Ordered And ADD Sizes
Your answer
Caps
$25
BHM Lapel Pin
$8.00
REGISTRATION(S) TOTAL
Your answer
MEMORABILIA TOTAL
Your answer
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