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11thACVVC REUNION
XXI KANSAS CITY, MO.
THURSDAY, SEPTEMBER 21, THRU SUNDAY, SEPTEMBER 24, 2006
Registration fee is $68.00 per person. This fee
is required for attendance at any of the scheduled program events
including Thursday and Friday Bunker Parties and Saturday Banquet
dinner. The registration fee will be an additional $10.00 to the
above price for registrations received after
AUGUST 27. 2006
PLEASE
PRINT ALL INFORMATION AND REGISTER EARLY
NAME_____________________________________TELEPHONE
NO._________________________
ADDRESS___________________________________________________________________________
CITY/STATE/ZIP_____________________________________________________________________
Telephone
Number____________________________ EMAIL ADDRESS________________________
Please
list only one Troop Or Company (i.e. B troop 66/67 or H Co 69-70)
UNIT
ASSIGNMENT__________________________ YEARS IN
COUNTRY___________________
Attendees
_____________________________________________ $_____________
_____________________________________________ $_____________
_____________________________________________ $_____________
_____________________________________________ $_____________
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 FIRST REUNION YES/NO
Send Check or
Money Order (no cash please) for the full amount, payable to 11ACVVC
REUNION XXI or complete information below for Visa or Master Card.
Check One
______VISA _______MASTER CARD
Credit Card Number_______________________________
Expiration Date Mo_______
Yr_________________
Signature___________________________________________ (Required)
Mail to 11 ACVVC
Reunion XXI
c/o Ollie Pickral
571 Ditchley Rd.
Kilmarnock, Va 22482
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