SS United States Conservancy Meeting and Celebration

Saturday June 9, 2007

Pre-registration Form

Name(s) of attendee(s) _________________________________________________________

Address _____________________________________________________________________

City _______________________________ State _________________ Zip ______________

Preferred Email Address(es)_____________________________________________________

Telephone ________________________________________

Will you/your guests attend the evening reception from 5-7 PM? (RSVP required.) _________

Media Affiliation (if applicable) ____________________________________________________

Affiliation with (or interest in) the SS United States ____________________________________

____________________________________________________________________________

Meeting Registration Costs and Tax-Deductible Contributions

________ Gala Luncheon - Independence Seaport Museum Spinnaker Room.

Luncheon charge is $20.00 per person.

____ Grilled Lemon Basil Chicken Breast ____ Balsamic Glazed Grilled Salmon

________ Voluntary Meeting Fee - While meeting registration fees are voluntary, we would be very grateful

for your contribution to help us offset meeting expenses. Suggested

contribution is $20.00 per person.

________ Tax-Deductible Donation - The SS United States Conservancy relies on donations and membership

fees. Even if you cannot attend the meeting, we would be very grateful for

tax-deductible contributions in any amount.

________ TOTAL Enclosed

Please make checks payable to the “SS United States Preservation Society."

Please return this form with payment to: