RAD (Square) Registration Form

JRAD (Credit Card) Registrations
Registration Fee: $
(Fee shown is per person. Total due will be calculated at the bottom after entering number of attendees)
Is this your 1st RAD?
Service retired from:
Pay Grade at retirement
Your Phone Number?
Format: (000) 000-0000.
Select appropriate boxes:
Additional Guest Option:
Retiree

First NameLast Name
Email

Confirmation Email
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Spouse / Guest

First NameLast Name
Additional Guest

First NameLast Name
Please Note:
All registered attendees are provided lunch. ONLY indicate the number of lunches below IF you have special dietary preferences.
Number of Vegetarian Lunches?
Enter the number requesting above, ONLY if you request this specific lunch.
Number of Gluten Free Lunches?
Enter the number requesting above, ONLY if you request this specific lunch.
Status:
Amount

USDDescription

JRAD (Credit Card) Registrations