------------------------------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:        012345 678   @ $75 PER PERSON: $ 

NUMBER ATTENDING NAVY YARD/ARLINGTON TOUR:                   012345 678  @ $55 PER PERSON: $

HOSPITALITY ROOM STIPEND:                                                           012345 678   @ $30 PER ADULT:  $

NUMBER ATTENDING BANQUET :                               012345 678   @ $68 PER PERSON: $ :

DINNER CHOICES:    SLICED TOP ROUND OF BEEF   012345 678    GRILLED SALMON    012345 678
                                 CHICKEN MILANESE    012345 678         PENE PASTA W/ GRILLED CHICKEN    012345 678

SPECIAL DIETARY NEEDS:  

FAVORITE BEVERAGES/SNACKS:  

MAKE CHECK PAYABLE TO:  ERIC H ERICSON GRANDTOTAL:   $ 

MUST BE IN BY AUGUST 10TH

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