Web Site Registration Form
Great Smokies Assembly
of York Rite Masons
Maggie Valley, NC
July 8, 9, 10, 2012

Please complete this form and return with your
check no later than June 15, 2012.
Make checks payable to:
Summer Assembly
and mail to
Robert Schafer - Grand Sceretary
P.O.Box 17212 - Raleigh, NC 27619

Name_________________________________________

Address ______________________________________

City _______________________________

State ______________________________

Zip _______________________________

Title ________________________________________

_________________________________________

Wife's Name __________________________

Guests Name:_________________________________

Registration Fee (Men Only) $ 20.00______________

Banquet Tickets $ 30.00 per person ______
    Children: $15.00 __________

Total Amount of Check............$_________


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