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

Eric H Ericson III------926 Savanas Pt Dr, APT A------Ft. 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 USMC MUSEUM/MT VERNON TOUR:          @ $75 PER PERSON: $ 

NUMBER ATTENDING NAVY YARD/ARLINGTON TOUR:                    @ $55 PER PERSON: $

HOSPITALITY ROOM STIPEND:                                                              @ $30 PER ADULT:  $

NUMBER ATTENDING BANQUET :                                 @ $68 PER PERSON: $ :

DINNER CHOICES:    SLICED TOP ROUND OF BEEF      GRILLED SALMON   
                                 CHICKEN MILANESE            PENE PASTA W/ GRILLED CHICKEN   

SPECIAL DIETARY NEEDS:  

FAVORITE BEVERAGES/SNACKS:  

MAKE CHECK PAYABLE TO:  ERICH H ERICHSON GRANDTOTAL:   $ 

MUST BE IN BY AUGUST 10TH

       

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