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

____________________________________________________________________________________________________

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