136TH SUPREME CONVENTION BALTIMORE, MARYLANDNEW JERSEY STATE COUNCIL
MATERIAL & STATE DINNER INFORMATION
Please indicate the items you are interested in & return this form by Friday June 22nd with your check payable to:
Donald S. Cleary 609-404-1640 don.me1010@gmail.com
10 Wicklow Terrace , Galloway, NJ 08205
Please note if your shirt order is not received by the above date your shirt will NOT be available for the Supreme Convention.
1. NJ State Council Dinner – Wednesday, August 8th at LaTavola Restaurant 248 Albemarle Street, Baltimore, MD 21202 - Time 6:30PM
Number of persons _____@ $60 per person = Total $_____
2. NJ State Hospitality Room activities:
Number of persons______ @ $55 per person = Total $______
3. NJ State Council Men’s Polo Shirts all include embroidered Logo on left (S.M.L.XL) Price is $30
Ladies Y Neck Polo with State Council Embroidered Logo on Left (S.M.L.XL) Price is $30
XXL-$2 Extra – XXXL-$4 Extra – 4XL-$6 Extra
Add On’s-all shirts
Men’s Pocket on left-State logo on right - $2 Extra Name on Shirt (Right Side)- $5 Extra
Name & Title (Right Side)- $8 Extra
NJ State Council Scarf for Ladies is $25
Name Desired on Shirt______________ Name:_____________________ Total Enclose $_________ Address:___________________________
Phone:___________ Email:____________
Protecting Gods Kingdom

Hospitality @ $55/Person includes:
Evening Refreshments Monday-Thursday
Lunch on Tuesday
Breakfast & Lunch on Wednesday-Thursday.
Remember: Deadline to sign up is June 22nd