To register, print this page, complete the form and send to the address below with a check written to:

                                           ASHC-VVA Reunion

                                           c/o Jeff Wojciechowski

                                             40 Tufts Trail

                                            Hopatcong, NJ 07843

                                      REGISTRATION  FORM

                              ASHC-VIETNAM VETERAN'S REUNION

                       

                        Dothan/ Fort Rucker AL                   2-4 October 2009

Name______________________________________ Spouse's name_________________________

Rank (if retired military______________________________________________________________

Address___________________________________________________________________________

City________________________________ State____________________Zip___________________

Home Phone____________________________E-Mail______________________________________

                                                                                                           ENTER AMOUNT BELOW

Reunion Registration  $40.00 Individual $45.00 Couples                 ____________

Dinner             $36.00 per person                                                      ____________

Bus/Tour        $15.00 per person                                                       ____________

 

Rucker  AM   PM    Dothan  AM  PM  (circle your choice/s)             ____________

TOTAL AMOUNT DUE                                                                        ____________

Make all checks payable to ASHC-VVA

For reservations, contact the Holiday Inn South, Dothan, Alabama at 334-794-8711 or 800- 777-6611.Our group code is 179th ASHC. The group room rate is $79.16 plus tax. There is no provision for online reservations.