AIR CAPITAL - 2017

Carnival Glass Club

Please pay annual membership dues at this time


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                    Last Name                                         First Name                                     Spouse

__________________________________________________________________

                    Address                                           City & State                                     Zip Code

                __________________________________________________________________

                      E-Mail Address  (required for Email newsletter)                                  Phone Number


               ANNUAL MEMBERSHIP  per Household

Printed: $20.00, Canada $22.50 Other $25.00        $_________

                                               OR

                                                Email:     PDF format    $20.00                                  $_________



If attending the Convention , please continue                                                       

CONVENTION REGISTRATION 2017

    

     Wednesday, October 4

          Breakfast at SOLOS - Free with hotel Reservation

          Early Bird Meal - No charge          Number attending __________

          View Auction Glass

     Thursday, October 5

          Breakfast at SOLOS - Free with hotel Reservation

          Seminar - Bill and Kenda Jeske

          Silent Auction Setup

          Hospitality Room Open

          BBQ Dinner - No charge               Number attending __________

          Seeck Auction Ends

     Friday, October 6

          Breakfast at SOLOS - Free with hotel Reservation

          Seminar - Cale Wilcox

          Silent Auction Ends

          Banquet Meal -

            Ron and Bert Doubler           Number attending __________@$25.00 ea              $__________

     

     Convention Registration - $5.00 per household                                                         $__________


     Raffle Tickets - for drawing of Imperial Octagon small size pitcher

          12 tickets for a $10.00 donation  Number of sheets ________ @$10.00 ea.               $__________


                                                                                                        Total enclosed:  $___________

   

     Make funds payable to Air Capital Carnival Glass Club

Print and send application and payment to:

Randy G. Thach, Secretary

4500 N. Ridge Road

Wichita, KS 67205











__________________________________________________________

   Address:_________________________________________________________

   Telephone:_______________________________________________________

   E-Mail Address:___________________________________________________

    Newsletter: Please check one:    Mailed:       OR  Online:  

  __________________________________________________________

   Address:_________________________________________________________

   Telephone:_______________________________________________________

   E-Mail Address:___________________________________________________

    Newsletter: Please check one:    Mailed:       OR  Online:  

    Family membership per year for US Members - $20.00(includes quarterly Newsletter)$_______

    Canadian - $22.50 & Other countries - $25.00           $_______

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Convention Registration and Annual Dues Payment Form