2008 Missouri Ducks Unlimited

State Convention Registration 

March 28-30, 2008


ADVANCE CONVENTION REGISTRATION FORM

NAME     ____________________________________

SPOUSE ______________________________________

ADDRESS _____________________________________

                ____________________________________

CITY, STATE, ZIP   _____________________________

TELEPHONE    ________________________________

DU CHAPTER   ________________________________

Enclosed is my check for: 
* $150.00 Couples (includes reception, Sat. lunch  &  banquet) 
* $100.00  Singles (includes reception, Sat. lunch & banquet) 
* $30.00  Saturday lunch only 
* $15.00  Childs plate Saturday banquet 
* $45.00  Saturday banquet only

Or charge my credit card:
Credit Card Type      _______________________________

Credit Card Number________________________________

Expiration Date       ________________________________

Signature_________________________________________

I will have the following number of family members attending the following functions:
No. ________________                Friday Casino Night
No. ________________                Saturday Luncheon
No. ________________                Saturday Banquet

Clip and mail with payment to:

Sharon Koch
101 Covert Lane
Ellisville, MO 63021
Fax 636-536-2322

Register by Feb 26th & your name will be entered in a special ‘early duck’ drawing.