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Bathyscaph Trieste QUESTIONNAIRE
  1. [.....] I have the following suggestions :
    ______________________________________
  2. [.....] My/Our preferences for beer is ______________________________________
  3. [.....] My/Our preferences for wine is ______________________________________
  4. [.....] My/Our preferences for soft drinks is ______________________________________
  5. [.....] I will be bringing a guest / a spouse.
  6. [.....] I will be bringing children under the age of 10.
  7. [.....] I will volunteer for the hospitality suite as host.
    on ______________(day)AM or PM Please circle one
  8. [.....] Name _________________________________
    Please Print-- First & Last
  9. [.....] Guest /Spouse ______________________________
    Please Print-- First & Last
  10. [.....] Address __________________________________
  11. [.....] City_________________ State________
    Zip Code_________
  12. [.....] Telephone Number ________________________________
  13. [.....] Social Security Number __________________________ Required For Access to SUB, BASE, BALLAST POINT, CA.)
  14. [.....] Email address __________________________________
  15. [.....] Dates on board _________________________________
    Month / Year On, Month / Year off
Mail to Stan Reinhold, 8318 N. 97th Avenue, Peoria, AZ 85345-3709.

Send with your registration fee of $35.00 per person.