22nd Infantry Regiment Society Reunion Registration Form Page 2 PRINT AND MAIL WITH PAGE I

Step1 Dues: (Check One)

  ___ I already paid my dues for 2017.  No dues are enclosed. 

  ____I am a Life Member.  No dues are enclosed. 

  ____ My dues for 2017 enclosed ($10 or $22 for a “Double Deucer rate”) 

 ____   I am on Active Duty with rank of E-5 or below (Special $4.00 rate) 

  _____ I want to be a Life Member (see rate below)  I was born in _________Year. 

Life Member Dues:   New rates effective January 1, 2006 

Age 90+ $30            Age 80-89 = $60      Age 70-79 = $100     Age 60-69 = $140      Age 50-59 = $190.00 

Age 40-49 = $230    Age 30-39 = $270    Age 20-29 = $310                         Step 1 Total:  _________

Step 2:  Mandatory Reunion Registration Fees  (Information for Name Badges) 

Registration Fees: Member or Associate  $20.00 , Guest (Age 18+)   $10.00 and Guest (under 18) no fee On site registration fee $25.00

       First Name                  Last Name                              City/State (if Dif.)               Registration Fee

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Please list special needs i.e.: wheelchair, etc.                                       Step 2 Total: __________

Step 3:  Group Meals and Entertainment 

Italian Buffet, Hemmingway Turkey, Night of Remembrance (Friday night)  No._____  @ $38.00  Total:  _____

Ladies Champagne Brunch     No._____ @  $15.00  Total:  _____

Saturday Banquet (HMOR/DMOR):    12 oz. NY Strip Steak   No._____ @  $40.00  Total:  _____

                                        Grilled Chicken Breast                                 No._____ @ $40.00  Total:  _____ 

                       ;                                                                                          Step 3               Total:  _________

Step 4: Optional Donation to offset reunion cost (Hospitality room)     Total:   _________

Step 5: Purchase of raffle tickets: $1.00 each or 6 for $5.00          No:________        Total: _________

Step 6: Donation Awb Norris Scholarship Fund                                                         Total: _________

 Total Amount enclosed (total of Steps 1, 2, 3, 4, 5, 6, )     $________________