Register

GPM 40th Reunion Registration Form

First Name

Last Name

What is city/town and state (or country) are you coming from?

Email Address

Cell Phone Number

Planned Arrival Date

Planned Departure Date

Will family members be attending with you?

Yes

If yes, how many additional people will be in your group?

May we include your name on a list of attendees?

Yes, feel free to include my name

No, I'd prefer my attendance to be a surprise

Would you like to make an additional donation to help others attend?

Yes

Maybe / I'd like more information

No, thank you

We can follow up personally with those interested in contributing.

Anything else you'd like us to know?

Event Fee: $75 per person

Payment may be made by:

Check payable to Bill O'Neill 75 Puritan Road Buzzards Bay, MA 02532

Venmo: @billowrites (Cell number ends in 2822)

Please submit payment shortly after completing this form. If payment timing is a concern, just let us know.