Registration

PRE-REGISTRATION FORM

You can download the Pre-Registration Form by clicking on this link.

Pre-Register by email or mailing your registration paperwork to Jonathan Sherbert. If you email your registration, and pay with PayPal or Cash App, you MUST send your email receipt of payment to vjsherbert@gmail.com.

  • To pay with PayPal, please send your payment to the following email address on PayPal: treasurer@asbalumni.com
  • To pay with Cash App, please send your full payment to $asbalumni

If you pre-register, you will be entered for a chance to win one of two $50.00 gift cards. Rooms are first come first serve. If you want a room/certain room/certain roommate, you should strongly consider preregistration. Pre-registration forms must be received no later than Monday, July 19, 2021. You are not preregistered until your payment in full has been received.

PLEASE PRINT


NAME____________________________________

ARE YOU AN AIDB STAFF MEMBER?

YES___ NO___

ADDRESS________________________________

CITY_____________________________________

STATE_________________________________

ZIP____________________________________

PHONE________________________________

CELL (optional)_________________________

E-MAIL ADDRESS
__________________________________________

GUEST(S) NAME(S) Needing to stay on campus. ** Please note that each member can ONLY register 2 guests. Anyone 5 years and older need to be registered. **
____________________________________________________________________________________________

NUMBER OF GUESTS NEEDING ROOM___________

LETTERS: LARGE PRINT______ BRAILLE______

BRASS: LARGE PRINT______ BRAILLE______ AUDIO______ EMAIL______

DIRECTORY @ $10:

LARGE PRINT______

BRAILLE______

EMAIL (FREE) ______

WOMEN
WARD 1______ WARD 2______

COUPLES
MONROE______ ORR______

MEN
WILLIAMS 1______ WILLIAMS 2______

NUMBER OF TICKETS & COST:

______ MEMBERSHIP DUES @ $10.00 EACH

______ REGISTRATION @ $20.00 EACH

______ BREAKFAST @ $5.00 EACH

______ BANQUET @ $10.00 EACH

______ Blues and BBQ lunch $10.00 (Sno Biz sold separately)

______ DIRECTORY @ $10.00 EACH

______ Transportation @ $25.00 Roundtrip fare (Birmingham)

DONATIONS:

BRASS DONATION __________

ALUMNI SCHOLARSHIP FUND __________

DON SIMS STUDENT ACTIVITY FUND __________

TOTAL AMOUNT DUE: _______________

Make checks payable to ASB Alumni. Be sure to include enough money to cover ALL items checked, including the directory.

SEND TO:

Jonathan Sherbert
276 Inglenook Lane
Sylacauga, AL 35151

Please remember that pre-registration forms must be received no later than Monday, July 19, 2021