This is the registration form for the Thursday, 9 February 2012, Luncheon in the Fort Richardson Room at the Army Navy Country Club, Arlington, VA with Major General Earl Matthews BIOGRAPHY, as our guest speaker. 

Please note:  As stated in our charter, these meetings are for AFC4A members, DAF Civilians, and other USAF Active Duty personnel who are currently serving in the AFC4 and XC communities.  Please do not bring guests outside these guidelines.

Our speakers have been assured that their remarks are off-the-record and not for attribution. 

Reservations must be made and paid by close of business Monday, 6 February.  If paid later, the cost will be increased as indicated below.  

Here is my registration information (and dues payment, if required) 

First name
Last name
Active Duty: Organization
Active Duty Only: Rank
Active Duty: Duty Title
Name Tag Should Read
Work Phone
E-mail

    My membership status in AFC4A is (select one please):

    Active Duty Air Force (includes DAF Civilians)
    AFC4A Member (paying 2012 dues of $20.00 with this transaction)
    AFC4A Member (dues have been Paid for 2012)

    NOTE:  Active duty (AF Military and DAF Civilian) personnel do not pay dues.

    Please select one of the following.

    Roasted Chicken Breast

    Pasta Primavera (Vegetarian)

     Served with Salad, Roll & Butter and Beverage.

    Before totaling your costs, please note the following:

    1.  As our charter states,  meetings are for AFC4A members, DAF Civilians and other USAF
        Active Duty personnel.  Please do not bring guests outside these guidelines.

    2. Our speakers have been assured that their remarks are for non-attribution and off the record.

    Please select the applicable column and total the amount you owe:

 *If you are paying in advance (no later than COB Monday February 6th), pay the indicated amount.

 RESERVATIONS SHOULD BE MADE AND PAID NO LATER THAN COB Monday, February 6th.

WALK-ONS without reservations will be charged $25 (Active Duty/DAFC) and $35 (AFC4A Members).

Items Paid 2012 Member Paying 2012 Dues Now Active Duty Air Force

Luncheon-Pasta Primavera(Vegetarian)

*$30.00

*$30.00

*$20.00
Luncheon-Roasted Chicken Breast *$30.00 *$30.00 *$20.00

AFC4A Dues 2012 ($20)

Paid

Not Applicable

Optional Donation to our Awards Program

Here is $3.00 for AFC4A Member Directory

Total Cost (pls. sum to total by typing over)

 $ $ $
Questions about the luncheon?  Call Jim Lauducci at 571-235-7087
Address or Directory Changes?  Send to Jack Stratford

 

By submitting this form, you are committing to pay the amount indicated above.

I will mail a check for the total amount indicated above to:

AFC4A
2002 Volley Court

Alexandria, VA 22308
Phone: (571) 235-7087

Thank you for making your reservation. Look forward to seeing you on Thursday February 9th.

Return to Home Page