Shrine Fundraising

Attendee Registration

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Number of Tickets (including your Lady) 1 2 3 4 5 6 7 8 9 10

Are you a past SFA/SCAFRA president? No Yes

First Name *

Last Name *

Title

 

Temple Name

Are you a voting rep? * Yes No

Noble's Cell Phone *

Noble's Email *

Lady's Name (If Attending)

Lady's Cell Phone

Lady's Email

Name of extra attendees (other than you & your Lady)

Are You Driving To The Seminar? * Yes No

 

Name of Airline & Arrival Flight #

Date/Time

Name of Airline & Departure Flight #

Date/Time

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Continue to payment