RAD (Square) Registration Form

RAD (Credit Card) Registrations

Important: Online registration requires online payment your credit card.
Registration Fee: $
Important: Online registration requires online payment with your credit card. (Fee is per individual person)
Your 1st RAD?*

YesNo
Service retired from:*
Pay Grade at retirement*
Your Phone Number?*
Email*

Confirmation Emailexample@example.com
Registering these for the RAD:*

Military RetireeSpouse of RetireeGuest of RetireeWidow of a Military Retiree
Retiree

First NameLast Name
Spouse

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guest

First NameLast Name
Widow

First NameLast Name
Number of Vegetarian Lunches?
Enter the number requesting above, if any.
Status:
Amount

Total Amount*

USDDescription

RAD (Credit Card) Registrations