PRINTABLE REUNION MEMBERSHIP DUES AND ORDER FORM

Print this form, fill it in and then mail to:

Rank attained: ___________________

E-Mail Address: ____________________________________________

Name: _____________________________________________Spouse: ___________________________________

Address: _____________________________________________________________________________________

City, State & ZIP: _______________________________________________________________________________

Phone Number: (______)_______-__________  USAF Retired? __________________________________________

401st Squadron(s) and dates you were in them: ______________________________________________________

My Membership @ $5.00 Per Year: (Minimum 2 Years)-> ________ Years ----------------> $_________

My Contribution To The Reunion Operation Fund: (Most contribute $25 or more)------> $_________

401st Wing Insignia Cap (White): -----------------------------------> Qty ____ @ $20.00 each = $_________

612th Squadron Cap (Blue): ------------------------------------------> Qty ____ @ $15.00 each = $_________

613th Squadron Cap (Black W/Yellow Letters): ---------------> Qty ____ @ $15.00 each = $_________

614th Squadron Cap (Red): ------------------------------------------> Qty ____ @ $15.00 each = $_________

615th Squadron Cap (Green): ---------------------------------------> Qty ____ @ $15.00 each = $_________

2005 Reunion Picture CD/DVD: -------------------------------------> Qty ____ @ $25.00 each = $_________ 

2009 Reunion Video DVD: ---------------------------------------------> Qty ____ @ $25.00 each = $_________

1993 Reunion Memory Book: ---------------------------------------> Qty ____ @ $10.00 each = $_________

                                                                             Pay with only one check.  Total enclosed:= $_________

Make check payable to “401^st TFW Reunion Association”.