SAME SF Post OMI/PMA Scholarship Fundraiser Form

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Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email

Individual Registration:

OMI/PMA Fundraiser – Individual Attendee – $20.00
OMI/PMA Fundraiser – Military/Government Attendee – $10.00

Sponsorship Purchases:

Included Registrations: Diamond = 10 Attendees / Gold = 5 Attendees / Silver = 3 Attendees

Additional Monetary Donation (Optional):

Name Additional Phone

Total

$0.00

Required:

I agree to abide by the SAME Code of Conduct while attending this event and understand that failure to do so may result in my being removed from the activity.

SAME Code of Conduct.