[Westark-list] Registration Form 2004 Second form

[Ed Adams]

WACHTSCHU MAWACHPO LODGE



WACHTSCHU MAWACHPO LODGE

 

2004 Registration Form

 

 

Please use the following to register for the listed events in 2004.

 

                                                                                                                                                                                         

 

          

_____Nov 5 - 7, 2004                                        Arrowman and Brotherhood Candidate

                                                                                 Registration Only!                                            

          Rogers Scout Reservation

          Registration Deadline Oct 22, 2004             Ceremonies - Brotherhood and Vigil Only

 

 

Fees:

 

Arrowman                                 $ 12.00         

 

Ordeal                                           

 

Brotherhood                               $ 27.00

________________________________________________________________________         

 

Name      __________________________________   Troop #_______

 

Address   __________________________________   Honor:  Ordeal  Brotherhood  Vigil

                                                                                                                  (Circle one)

City  ________________  State ____  Zip Code ________

 

Phone _______________  E-Mail ________________________________

 

Chapter (Circle One)  BT  RZ  OZ  MM

 

Complete one form for each person attending and mail with the fee(s) to:

 

Wachtschu Mawachpo Lodge

1401 Old Greenwood Road

Fort Smith, AR 72901

Ph # 479-782-7244

 

Please bring the appropriate medical form to camp with you!

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