Registration Form for 2017 Reunion

Bilmar Beach Resort, Treasure Island, Florida

 

Names of Attendees: __________________________________________________________________

Street Address:_______________________________________________________________________

State and Zip: __________________________________Phone #: _____________________________

CAC/CAP Unit:_______________________________Indicate if you need an ADA Room: __________

Activities and Fees Paid Upfront except where indicated:†††††

Registration Fee:††††††††††††††††† Number ____________ at $30/person.Total is:___________________

Fri 10 Nov: Tampa Zoo at $49 per person:Number _______ at $49/person.Total is: _____________

Fri 10 Nov: Dinner Cruise at $55 per person:Number ______ at $55/each.Total is: ______________

11 Nov:Victory Ship Museum at $25 per person:Number ______ at $25 ea.Total is: ____________

11 Nov:Banquet Dinner at $38 per person.Number ________ at $38 each.†† Total is: _____________

#Pepper Crusted Sirloin _________# Grilled Chicken Breast __________ # Grilled Mahi ___________

12 Nov:St. Peteís Garden at $28 per person:Number _________†† at $28 ea.Total is: ____________

12 Nov:Ybor City at $20 per person:†† Number __________ at $20 ea.††† Total is:_________________

12 Nov:Golf at MacDill AFB.†† Driverís License number: _____________________________________

Annual Dues at $20.†††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† †††††††††††††††††††††††††††Total is: ________________

Additional funds donated to Association†††††††††††††††††††††††††††††††††††††††††††††††††††††††††† Total is: ________________

Make Check out to Russell B. Longway Trust Fund.Must be received by

15 August 17to assure coordination of transportation.†† ††††††††††††Total Submitted: ________________

Mail check and registration form to:Mike Murphy, 4645 West Gail Drive, Chandler AZ 85226