M’SHIP APPL’N 07-08+ & Þ’BLOT 08 RESVN FORM (NEW 09/04) OFFICE USE ONLY: # ________
FIELDS MARKED WIITH * ARE REQUIRED PLEASE PRINT CLEARLY NEW INFO: YES NO
ICELANDIC-AMERICAN ASSOCIATION OF HAMPTON ROADS, VA
MEMBERSHIP for YEAR 2007-2008 (ending on/about June 17TH 2008)
MEMBERSHIP: Application Renewal - ANNUAL DUES: $10. Family $8. Individual
Payment method: Cash Check/Money Order- # _______ , Date __________ $ ___.___
Please remit to the Association Secretary c/o 185 Commodore Dr, Norfolk VA 23503-4802
Make check/money order payable: ICELANDIC-AMERICAN ASS’N H.R. Do not mail cash!
Family name* ____________________________ Woman’s maiden name* _____________________
(Please abbreviate “…..sson” as “…..s’”) (Please abbreviate “…..dóttir” as “…..d’”)
Man’s first name* _________________________ -“- first name* _______________________
-“- middle name _______________________ -“- middle name _____________________
-“- nickname* _________________________ -“- nickname* _______________________
-“- occupation ________________________ -“- occupation ______________________
-“- birth date: mm ____ dd ____ yy_______ -“- birth date: mm ____ dd ____ yy ____
_____________|_____________ nationality at birth//present citizenship __________|___________
Street address*________________________________________________ Apt./Unit/Floor*# ________ -
City* __________________________ State* _______________ Zip* __________- _______
Home Tel. #* ( ) _____-______ Office Tel, # ( ) ____-_______ Cellular #* ( ) _____-______
E-mail address* __________________________________ Pager No. ( ) _____- ______ V T#
Children less than 23 years old: name(s), sex, DOB (mm/dd/yy), & student status – List on reverse
RECOMMENDED BY?: _______________________________________________WHEN? __________
I/We subscribe to “The Association’s” by law(s): [initials] x ______ x ______ date m___d___y____
ÞORRABLÓT 2008 (February 2nd, 2008)
[FULL NAME(S) REQUIRED - PAYMENT IN FULL DUE UPON RESERVATION - PLEASE DO NOT SEND CASH]
MEMBER NAMES: * ________________________________ * ______________________________
[$15.00 each] *________________________________ *_______________________________
GUEST NAMES: * ________________________________ * ______________________________
[$30.00 each] *_________________________________ *_______________________________
How many? Þorramatur ____ American fare ____ Both ____ || SEATING WITH? ________________
*TOTAL REMITTED: $ ______._____ *CHECK/MONEY ORDER #: ____________ DATED: _________
[Make checks/money orders payable to ICELANDIC-AMERICAN ASS’N H.R. – Please remit to the Association Secretary]
WILL YOU HELP WITH THE V.F.W HALL SET-UP AT 9:00 AM to 1:00 PM ON SATURDAY, FEBRUARY 2nd? YES NO
Will you require Best Western Holiday Sands hotel reservations? YES NO OTHER ________
