NAME:

ADDRESS (Street, City, State, Zip):

HOME PHONE:

WORK PHONE:

EMAIL ADDRESS

YEARS IN VIETNAM IN ALPHA COMPANY, e.g. 68-69

BIRTH DATE:

MARRIED?

YES -- SPOUSE'S NAME

NO

I PLAN ON ATTENDING THE 2006 REUNION IN NASHVILLE, TN?

 YES

NO

          TOTAL NUMBER ATTENDING FROM YOUR FAMILY?

          NUMBER OF KIDS ATTENDING UNDER AGE OF 12

          I HAVE MADE RESERVATIONS AT REUNION HEADQUARTERS, 
          RADISSON HOTEL OPRYLAND AT 1-615-231-8888

YES, NUMBER IN PARTY

NO, BUT I'M PLANNING TO.

NO, I WILL STAY ELSEWHERE IN THE AREA.

I WOULD LIKE TO REGISTER FOR THE FRIDAY GROUP BUS TRIP TO FORT CAMPBELL (ABOUT $30/PERSON)

YES, NUMBER PARTICIPATING

NO

I WOULD LIKE TO REGISTER FOR THE FRIDAY EVENING PERFORMANCE OF THE GRAND OLE OPRY (ABOUT $30/PERSON)

YES, NUMBER PARTICIPATING

NO

I WOULD LIKE TO REGISTER FOR THE SATURDAY LUNCH CRUISE ON THE GENERAL JACKSON SHOWBOAT (ABOUT $30/PERSON)

YES, NUMBER PARTICIPATING

NO

I AM PLANNING TO PARTICIPATE IN THE SATURDAY EVENING BANQUET (ABOUT $18/PERSON)

YES, NUMBER PARTICIPATING

NO

DOES ANY MEMBER OF YOUR FAMILY REQUIRE SPECIAL DIETARY NEEDS?  LIST:

DOES ANYONE REQUIRE HANDICAP ASSISTANCE OR SPECIAL ROOM NEEDS?

ANY COMMENTS?