RESERVATION FORM NOT DESIGNED FOR SMART PHONES 

ALL ATTENDEES 
MUST PAY A $20 REGISTRATION FEE

LADY'S BREAKFAST & TEA ARE COMPLIMENTARY - BUT WE NEED TO KNOW NAME FOR TICKETS AND PLANNING 

INSTRUCTIONS: FILL OUT THE FORM

PRINT 2 COPIES

MAIL 1 COPY WITH YOUR CHECK PAYABLE TO AMD-USA

TO: Moises I. Gomez, 

      526 Kaplan Street,

      Roselle, New Jersey 07203

THEN"RIGHT CLICK" ON SUBMIT BUTTON

BRING 2ND COPY WITH YOU TO GET TICKETS

NOTE:THE REGISTRATION BLOCK
MUST BE FILLED OUT 
TO ENABLE THE "SUBMIT BUTTON TO WORK"