Day Use Pass Request and Processing Form
Print this form when ordering the Annual Day Use Pass via
the mail. (Discount passes must be purchased in person
with the appropriate passport and identification.)
What Do
You Want To Purchase?
(Fill in number of passes and fill in amount
due.)
This pass entitles the holder and all accompanying
passengers to use any designated day use facilities operated by the Corps of
Engineers.
This pass is valid for 12 months from the date of puchase.
This pass (hangtag) may be used on any vehicle the passholder
owns, therefore duplicate passes are not needed.
More than one pass may be purchased at full price if desired.
Mail completed request form and payment to:
Pomona Lake Project Office
U.S. Army Corps of Engineers
5260 Pomona Dam Rd.
Vassar, Kansas 66543
Make checks or money orders payable to: “USAED, Kansas City”About You
Name:
Date:
Address:
City, State, Zip:
Phone (xxx)xxx-xxxx:
Item |
# |
Cost |
Due |
Annual Day Use Pass |
|
$30.00 |
|
TOTAL |
$ |
Payment (Make check or money order payable to “USAED, Kansas City”)
Check or Money Order |
Amount |
Check Number |
|
||
Do Not Send Cash. |