REGISTRATION FORM

      Surname : ………………………………………   Name : ………………………………………..

           Postal Address : ………………………………………………………………

                                     ………………………………………………………………

                                     ………………………………………………………………

           Email address :   ……………………………………

           Telephone : Res : ………………………………  Mobile:   ………………………………

          Years at Yercaud  :……………………………..

          Capacity attending :   Student  (    )  Teacher    (    )     Other  ………………(    ) 

          I have received information about the forthcoming reunion.(    ) 

          I will be attending  (    ) 

          I am keen to attend but would like to confirm later. (    ) 

          I need more information, time to decide etc. (    )          

          I cannot attend but i will be there in spirit. (    ) 

          I will also forward this info on to other montfort boys & shy girls.(    ) 

         Other ………………………………………………………………………………………….

         Please advise any special dietary needs :

            Non Vegetarian  (    )   Vegetarian   (    )  Other ………………………(SPECIFY)

         Please advise if assistance with accomodation is required.

          I reside in Victoria and do not require accommodtion  (    )            

          I Wish to stay in a hotel / motel (    )          

          I have family / friends i will be staying with (    ) 

          I would like to be accomodated in a family home. (    ) 

Print and Post completed form to: Melbourne Organising Committee, 757 Highbury Road, Vermont South, Victoria 3170, Australia. or email as attachment to: montfort_shy@hotmail.com