-                                                    REGISTRATION FORM                                                 - 

 11th ACVVC Reunion XXIII, Rosemont, IL 

11acr.gif (5566 bytes)Thursday, 21 August thru Sunday, 24 August 200811acr.gif (5566 bytes)

 

PLEASE MAKE YOUR OWN HOTEL RESERVATIONS AT

Hyatt Regency O’Hare, 9300 W. Bryn Mawr Ave.

Rosemont, IL 60018  847-696-1234   800-233-1234

 

Registration fee is $75.00 per person. This fee is required for attendance at any of the scheduled events including the Thursday and Friday night Bunker Parties and the Saturday Banquet dinner.

Please register early.  Deadline for registrations is August 1, 2008.  The registration fee will be an additional $25.00 per person for registrations received after that date.

 

PLEASE PRINT ALL INFORMATION

 

Name__________________________________________Telephone No:___________________

Address___________________________________________________
City/State/Zip __________________________________________________________________

E-Mail Address_________________________________________________________________

Unit Assignment_________________________   Years in Country _____________________

                                (Example: B TRP, D CO )                                                                         (Example: 1966-1967)

ATTENDEES                                                    

__________________________________________________________           $____________

__________________________________________________________           $____________

__________________________________________________________           $____________

__________________________________________________________           $____________

Registration Fee Total        $____________

 

Banquet Meal Selection (Choose one selection per attendee)  Chicken_______Beef_______Veggie___

 

Special Diatary Needs:   q Yes   q No   (Please indicate needs) _____________________________

 

Is this your first reunion?  q Yes   q No            KIA Relative?  q Yes ________________________  

 

WHEELCHAIR OR OTHER MOBILITY EQUIPMENT RENTAL INFORMATION

Please Contact:  Mark Drug, Home Health, 800-253-6344 or 847-895-0011

They will deliver to and pick up from the hotel

 

q Visa   q MasterCard     Card No._________________________  Exp. Date ___________

 

Signature (Required for credit card) ___________________________________________

 

Make checks payable to 11th ACVVC.  Please mail Registration Form along with payment to:

11th ACVVC TREASURER  C/O OLLIE PICKRAL
571 DITCHLEY RD

KILMARNOCK, VA 22482