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ST. LAWRENCE BRANCH
UNITED EMPIRE LOYALISTS'
ASSOCIATION OF CANADA

 Loyalist crest

Personal Information

Name___________________________________
Address_________________________________
City________________       Province___________
Postal Code__________________

Telephone number
(____)_________________

E-mail___________________________

Trip Information


Doblue Room _____ Sigle Room _____

Smoking Room _____ Non Smoking _____

Special diets ________________________________________
                      ________________________________________
                      ________________________________________

Emgerency Contact ____________________________________


To send this off in an email copy into word or wordpad and then send
as an attachment to one of the contacts on the previous page.