(print out this form, fill out and mail to below address with your check)
REGISTRATION FORM - PLEASE COMPLETE AND MAIL IN

YOUR NAME____________________________

GUEST NAME___________________________

DATE OF SERVICE ON PROVIDENCE______________________

 

 

Number

Amount

Hospitality Room - $25 per family

 

$25.00

WRIGHT-PATTERSON MUSEUM TRIP - $65.00 per person

 

 

CINCINNATI MUSEUM CENTER TRIP - $50.00 per person

 

 

Hofbrauhaus Braumeister’s Brewery Tour
                        And Bier Tasting additional $6.50 per person     

 

 

TURFWAY PARK TRIP - $40.00 per person

 

 

BANQUET:

 

 

Herb Chicken - $25.00 per person

 

 

Roast Tip Sirloin of Beef   - $30.00 per person              

 

 

Baked Cod - $25.00 per person

 

 

Choose your dessert

 

 

Apple Pie

 

 

Carrot Cake

 

 

Special Dietary Requirements, please advise.

 

 

TOTAL enclosed

 

 

Return with check payable to USS PROVIDENCE ASSOCIATION as soon as possible to 
Bill McCubbin
USS Providence Association
3444 Senour Road
Independence, KY    41051
 
Drinks and Snacks are always available in Hospitality Room.   Please advise your preference of beer and/or alcoholic beverage as well as soda.
 
Also, anyone wishing to donate raffle item(s) please let me know. .........Bill McCubbin
Tel: 859-356-3711

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