Convention Registration Form
(To Be Updated for 2023 Convention)

When you complete this registration and meal form, please send a check for the appropriate amount made out to the “MAINE ELKS ASSOCIATION.”

Send to:

Carlette Eaton
c/o Waterville Elks LOdge #905
76 Industrical St.
Waterville, ME 04901
ATTN: CONVENTION COMMITTEE

Only one registration form per Elk Member. (An “Elk Member” cannot be considered a “Guest”)

CONVENTION REGISTRATION FORM

First Name

Last Name

Home Address

City

State

ZipCode

Home Phone

Cell Phone

Please verify that your e-mail is entered correctly.

Lodge Name & Number

Lodge Title

Exalted Ruler, Leading Knight, Secretary, Member, etc.

Non-Maine Lodge

NON-MEMBER GUEST

Include Guest First & Last Name-Remember and Elk Member is not a "Guest."

Friday Night Banquet-Member Meal

All meals include Rice Pilaf, Vegetable, Salad, Rolls & Butter, and Dessert

Quantity

Amount

Friday Night Banquet-Guest Meal

All meals include Rice Pilaf, Vegetable, Salad, Rolls & Butter, and Dessert

Quantity

Amount

Saturday Night Banquet-Member Meal

All meals include Mashed Potatoes, Vegetable, Salad, Rolls & Butter, and Dessert

Quantity

Amount

Saturday Night Banquet-Guest Meal

All meals include Mashed Potatoes, Vegetable, Salad, Rolls & Butter, and Dessert

Quantity

Amount

Member Registration (required)

Member Regisration Fee: $25.00

Quantity

Amount

Late Fee of $15.00

Check if After April 1, 2022

Total Amount Payable to the Maine Elks Association

If you are human, leave this field blank.

Convention Registration Form(To Be Updated for 2023 Convention)