11thACVVC REUNION XXII
LOUISVILLE, KY (Registration Form)

(Make hotel reservations separately at:
THE GALT HOUSE, 140 N FOURTH ST, 40202
1-502-589-5200 or 1-800-THE GALT
(843-4258))


THURSDAY, SEPTEMBER 6, --- SUNDAY, SEPTEMBER 9, 2007

Registration fee is $78.00 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 REGISTER EARLY!! The registration fee will be an additional $10.00 PER PERSON for registrations received after AUGUST 10, 2007!

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 $78.00)

Banquet Meal Selection (Choose one per Banquet Attendee)

CHICKEN____________________ BEEF___________________ VEGGIE_______________

Special Dietary Needs Yes___No___ If yes please indicate needs
 

Wheelchair Accommodations Needed---Yes___No___

Is this your first Reunion---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