REGISTRATION FORM

27th Annual 11th ACVVC Reunion

Orlando, Florida

Wednesday, 12 September thru Sunday, 16 September 2012

 

PLEASE MAKE YOUR OWN HOTEL RESERVATIONS AT

Rosen Centre Hotel

9840 International Drive

Orlando , Florida 32819

Reservations: 800-204-7234

 

Registration fee is $90.00 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.  The registration fee will be an additional $25.00 per person for registrations post marked after AUGUST 29, 2012.  All registrations must be received no later than Friday, SEPTEMBER 7, 2012.

 

 

PLEASE PRINT ALL INFORMATION

(print clearly or use mailing label)

 

Name_____________________________________________Telephone No:______________________

Address______________________________________________________________________________City/State/Zip ________________________________________________________________________

E-Mail Address_______________________________________________________________________

Unit Assignment__________________________________   Years in Country _____________________

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

ATTENDEES (please print)                                                    

__________________________________________________________            $____________

__________________________________________________________            $____________

__________________________________________________________            $____________

__________________________________________________________            $____________

Total Registration Fee                                                                                          $____________

 

Banquet Meal Selection (Choose one selection per attendee)  Chicken_______Beef_______Veggie_____

 

Is this your first reunion?  q Yes   q No        Wheelchair or special needs seating?  q Yes    q No    

 

KIA Relative?  q Yes   Name of KIA:  ____________________________________________________

 

Relationship to KIA:  ________________________  Unit: _____________________________________

 

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

C/O OLLIE PICKRAL

  571 DITCHLEY RD

KILMARNOCK , VA 22482