------------------------------Complete form, print and mail to:------------------------------

Eric Ericson, III------926 Savanas Pt. Drive, Apt A------Fort Pierce, FL------34982-5163

          YES! I/we plan to attend the reunion!                   RANK/RATE:  

FIRST NAME:   LAST NAME:   YEARS ON BANG:   TO 

ADDRESS:     PHONE:  ()  

CITY:   ST:  ZIP:    E-MAIL:  

SPOUSE'S/GUEST'S NAME(S):  

ARRIVAL DATE: DEPARTURE DATE:


NUMBER ATTENDNG MARINE CORPS AND MOUNT VERNON TOUR:                                   @ $73 PER PERSON.                    TOTAL COST

NUMBER ATTENDING NAVY YARD AND US CAPITOL TOUR:                                                               @ $55 PER PERSON.      TOTAL COST

NUMBER ATTENDING BANQUET  :                                                                          @ $65 PER PERSON.      TOTAL COST

DINNER CHOICES:
SLICED TOP ROUND OF BEEF                                                                                                                        

GRILLED SALMON                                                                                                                                            

CHICKEN MARSALA                                                                                                                                     


SPECIAL DIETARY NEEDS:  

HOSPITALITY ROOM STIPEND PER ADULT:                                                                                                                           @ $30 PER ADULT.

MAKE CHECK PAYABLE TO:  Eric Ericson, III                                                                              TOTAL:    $ 

MUST BE IN BY JULY 30th


GENERAL QUESTIONNAIRE - WHAT WOULD YOU LIKE TO SEE IN THE HOSPITALITY ROOM?:

BEER BRAND LIQUOR/WINE TYPE MIXERS
SOFT DRINKS SNACKS

Note: print this form in "landscape" layout rather than "portrait".

       

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