Form Page: LAform

Registration Form

Form Instructions

Read the Form Instructions (link above) first. Then enter your information and verify its accuracy before submitting. When finished, click the "Submit" button.

First Name

Last Name

Address

Address ( Cont.)

City

State/Province

Zip/Postal Code

Country

Phone

Requests/Comments

2023 Olympin Club Member?

If you are not a member and are registering for a table you must join Olympin Club.

Click To Join

Tables

Enter number of tables desired: $175 each.

Welcome Reception

Silent Auction

Enter number that plan to attend each free event. Registration is required.

Banquet

Pasta

Chicken

Banquet is $70. Enter the number of each item desired.

I agree to the Terms and Conditions

Terms and Conditions

Total amount due:

U.S. Bank Check

Money Order

Please indicate type of payment:

Pay PayPal

If Paying by PayPal, check the box and click the "Pay PayPal" link next to the box. Make the payment to treasurer@olympinclub.com. Make checks and money orders payable to Olympin Collectors' Club and mail to: The Olympin Collectors' Club, C/O Jonathan Becker, 800 Village Walk #258, Guilford, CT. 06437.