THE HOUSE OF JOSSEY-JOSEY   
April 25-27, 2003
Valdosta , Georgia
 
R E G I S T R A T I O N   F O R M

NAME _______________________________________________________
           (Last)               (First)             (Middle)        (Maiden)   PLEASE PRINT    

HOME ADDRESS ________________________________________________
                                (Street /P.O. Box)                     (Apt. #)

______________________________________________________________________
(City)                           (State)                            (Zip Code)        (Country - Other than USA)

HOME PHONE  (         )   ___________________ HOME FAX (    )  _________________

YES  WE PLAN TO ATTEND THE HOUSE OF JOSSEY-JOSEY REUNION 2003.     
Please list names of other immediate family members that will attend.                                                                                                                                                                                                                                       

WE WILL ARRIVE FRIDAY & WILL ATTEND THE BBQ & BANQUET.
WE WILL ARRIVE SATURDAY & WILL ATTEND THE BANQUET.
YES, WE WILL BRING ONE OR MORE DOOR PRIZE ITEMS.

Please return completed Registration Form by March 31, 2003 to:

Mrs. Jackie Helfrich, Secretary/Treasurer
4526 South Cortez Avenue
Tampa , FL 33611-2110

If you returned the Jossey-Josey Family Reunion Survey Form last Fall indicating your intentions for attending the Reunion, you will not need to submit a new Registration Form unless your intentions have changed.
Membership Dues (optional) and Registration Fees payable upon arrival.  

LOOK
PRINT, COMPLETE AND  
MAIL FORM TO JACKIE

THEN
 
LOOK 
FOR MORE 
JOSEYS 
AND 
PRINT OUT ANOTHER FORM AND INVITE THEM