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11thACVVC REUNION
New registration info pending check back at a later date
(Registration Form)
(Make hotel reservations separately at:
Registration fee is $88.00 per person. This fee is required for
attendance at any of the scheduled program events including the “Bunker”
on Thursday and Friday, lunch on Saturday at Fort Knox and the Saturday
Banquet. (Transportation to Fort Knox and lunch at Fort Knox is included
in the Registration Fee)
PLEASE PRINT ALL INFORMATION AND REGISTER EARLY!
NAME_____________________________________TELEPHONE
NO._________________________
ADDRESS___________________________________________________________________________
CITY/STATE/ZIP_____________________________________________________________________
EMAIL
ADDRESS____________________________________________________________________
UNIT ASSIGNMENT__________________________ YEARS IN
COUNTRY___________________
(Troop, Company or Detachment) (i.e. 66/67)
Please list only one Troop or Company (i.e. B Troop 66/67 or H
Company 69-70)
Attendees
______________________________________________
$_____________
______________________________________________ $_____________
______________________________________________ $_____________
______________________________________________ $_____________
REUNION REGISTRATION FEE TOTAL: $_____________
(Number of attendees x $88.00)
Banquet Meal Selection (Choose one per Banquet Attendee)
CHICKEN____________________ BEEF___________________
VEGGIE_______________
Special Dietary
Needs YES/NO, If yes please indicate needs
Wheelchair
required YES/NO
Send Check or Money Order (no cash please) for the full amount,
payable to 11ACVVC REUNION XXII or complete information below for Visa
or Master Card.
Check One: VISA _______MASTER CARD_______
Credit Card Number: _____ ______ ______ ______
Exp Date: Mo_____ Yr______
Signature___________________________________________ (Required for MC
or Visa)
Mail to: 11 ACVVC Reunion XXII
c/o Ollie Pickral
571 Ditchley Road
Kilmarnock, VA 22482 |