H.A.G.G.I.S MEMBERS

BURNS SUPPER RESERVATIONS

& MEMBERSHIP RENEWAL

If you browse with scripting off (or run a plug-in on your browser such as NoScript), you will need to turn scripting on for this form to work. The online form cannot be made to work otherwise. If you prefer to not use a script, you will have to mail your registration in the old-fashioned way.

Please fill out this form and click Submit. If you have questions about reservations or need to make changes, please email Burns2016@haggis-iowa.com

This year's Burns Supper event is at the GLOVIK PARISH CENTER at St Wenceslaus on 30 January 2016. St Wenceslaus Church, 1224 Fifth St SE, Cedar Rapids, IA

Please enter your name:
Please enter your email (optional):
Enter names of guests here (one per line, include age and gender for kids, please):
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Name Age Gender
Number of Adults (x $15.00):
Number of Children (x $5.00 6-18, under six free):

MEMBERSHIP

Memberships are due yearly by Tartan Day ~ April 6 every year! You may pay now if you wish.

Annual Dues are $13.00 for single membership and $17.00 for household membership.

Lifetime memberships are $200.00

Please print the following information clearly and completely, so we may keep our membership and e-mail lists up to date.

Name(s) in which membership is to appear:

Mailing address:

Phone number(s):

E-mail address: (we send information via e-mail periodically)

Please list any particular talents or interests you have to share:

As a member, I agree to volunteer time and talent for events and fund-raisers, as I am able.

Membership: (Mark one)

Please write separate checks for the dinner and for membership, for bookkeeping ease. Send form and payment check(s) to:

H.A.G.G.I.S.

P.O. Box 10212

Cedar Rapids, IA 52410-0212

If you have questions about reservations or membership dues, contact Lynne McDole at burns2016@haggis-iowa.com
Click here to submit