Coupons
Christmas Party Reservation Form Christmas Party
Please make my reservation (s) for the Okane Fall Christmas Party to be held on Tuesday, December 20,2022 at the Legion Hall. Party starts at 6pm, with dinner to be served promptly at 6:30.
Please find enclosed my check ($5 per person) in the amount of $_______ payable to FDNY Retired.
Please mail to Jim Barry, 8209 Cavalry Drive, Bayonet Point Fl before the cut off date of November 15, 2022.
********************************************************************************************************************************************************************************************************************************************************************************* 2023 CLUB DUES – NOTIFICATION
Your 2023 dues will be due Jan 31, 2023. The club dues is 20 + $5 for the Widows/Survivors Fund. Avoid the rush & be the first to pay your 2020 dues. Simply fill out this coupon & mail in with your check payable to FDNY Retired . Most important, please legibly print your current email address. This will enable us to keep the club’s email list current & enable you to continue to receive club info via the internet.
Member’s Name_(print)_________________________________________________________________________________________________
Spouse’s Name____________________________________ Pension # (Include all letters & numbers)_____________________________
Address_______________________________________________________________________________________________________________
Tel_____________________________________Email____________________________________________________Birthday______________
Dues $20 plus $5 for the Survivors Fund. Make checks payable to FDNY Retired
Mail to: Mike Doyle, Financial Secretary, 10838 Candy Lane, New Port Richey, Fl. 34654
APPLICATION FOR BOOSTER
PLEASE PRINT BOOSTER APPLICATION PLEASE PRINT
Please insert the following booster(s) in the newsletter. Each Booster costs $5 & will run for one year starting with the next issue. Be sure to include your name as the “DONOR”. Make checks payable to FDNY Retired, Mail to: FDNY Retired, Box 76, Port Richey, Fl 34673-0076
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Donor’s Name_______________________________________________________________________________________
APPLICATION FOR MEMBERSHIP IN THE GENE OKANE DIVISION OF FDNY RETIRED
GENE OKANE DIVISION OF FDNY RETIRED
POST OFFICE BOX 76 – PORT RICHEY, FL. 34673-0076
Please print all information
Name___________________________________________________________________________________________
Address_____________________________________________________Date Of Birth________________________
City_____________________________________________________State________________ Zip_______________
Phone__________________________________Email____________________________________________________
Badge #___________Rank_________Pension Number (include all letters & numbers)_____________________
Date Appointed__________________________________To Unit__________________________________________
Date Retired_____________________________________ From Unit_______________________________________
Units Worked In __________________________________________________________________________________
Retired (check one): For Service _________ Ordinary Disability_________Line Of duty Disability __________
Do you pay retirement dues to UFA or UFOA? Yes_______ No_________
Wife’s Name___________________________________Wife’s date of birth ________________________________
Email address if any ___________________________________________
Summer address if applicable & dates you will be there:
Address_________________________________________________________________________________________
City_______________________________________State_______________ Zip______________________________
Phone_____________________________ Email (if different)____________________________________________
Dates you will be there ______________
Mike Doyle , Financial Secretary
7102 Grand Blvd., New Port Richey Fl, 34652
(727) 819-8824
Please include a check for $25 ($20 for dues, $5 for Widows/Survivors Fund)
Make check payable to: FDNY Retired