www.ustnaamh.org

UST Nurses Alumni Association of Metropolitan Houston

12783 Capricorn, Suite 600 Stafford, TX 77477 Tel (832) 677.1599

Registration Form

UST 400th YR CELEBRATION

USTNAA NATIONAL CONVENTION AND LEADERSHIP SUMMIT

SEPTEMBER 8-11,2011

HOUSTON,TEXAS Name of Attendee:____________________________ Year Graduated __________________ Address:____________________________________ Email address:____________________ Contact No:_________________________________ Solicited by:______________________

Signature___________________________ Date_________________________ PLEASE MAKE CHECK PAYABLE TO USTNAAMH MAIL TO REYNALD TAPIA 12873 CAPRICORN DR STE 600 STAFFORD,TEXAS 77477 TEL NO (832)677-1599

Event Name # People Price Total amount

Welcome Reception Sept 8,2011 6PM-12MN

x $50.00

Educational Conference Sept 9,2011 7:30AM-3:25PM

x $50.00

Gala Dinner/Dance Sept 10,2011 6PM-1AM

x $65.00

Dinner Cruise Sept 9,2011 **Advance reservation Required before July 15, 2011

6PM-9PM

x $79.00

2010-2012 Executive Board

President Reynald Reyes Tapia

President-Elect Cecilia Reyes Bauri

Vice-President

Marvic D. Collado

Secretary Marissa C. Loveless

Treasurer Cora Tobias Boquiren

Public Relations Officer Erlinda Mantaring-Claire

Business Manager Marilyn Blodgett

Auditor Thelma Puspos

Board of Directors

Leticia Caeg

Angie Lautchang Norma Manlangit

Mila Uy

Executive Director

Jaime Puspos

Advisory Board

Ampy de la Paz

Lucy de Villa Emily Linan Serrano

Cherry Medrano-Sloan

Jessica Tecson Merlita Velasquez

Web Master Robert Medrano