2025 IALOH Annual Convention Form

2025 IALOH Convention Registration

April 24 - April 28, 2025
FORM AND PAYMENT MUST BE RETURNED BY JANUARY 24, 2025
Make checks payable to "IALOH" and mail check to:

David Smith

Convention Registration Chairman

1018 SW Walter Ave

Lake City, FL 32024
Name*

First NameLast Name
Noble Name On Badge
Title/Position
Shrine Temple
Lady/Guest Name

First NameLast Name
Lady/Guest Name On Badge
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
To select a convention item click the check box next to the item and enter the quantity.
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Convention Registration Fee
Registration Fee is per person

$50.00 Quantity

Total

$0.00
Additional Information
Should be Empty: