5^TH COMMUNICATIONS GROUP ASSOCIATION

Twenty Second Annual Reunion, Chattanooga, TN.

Sept. 26^th/October 3^rd 2010------Registration Form

Make Checks Payable to: 5^th Comm Grp. Assn

Mail this form & check to: Mr. Don Zechman

ASAP but NLT 15 Sept 2010 103 Dinius Ave PO Box 172

Middleburg, PA. 17842-0172

Did you or will you have a 50^th Wedding Anniversary in 2010? Yes/No

Name:_____________________ Wife/Guest Name__________________

Address:_________________________Tele. NO.____________________

Date: Activity Cost/pp #In Party Total

Wednesday 29 Sept. Registration . Hospitality Room will be in Penn Station.

$40.00/pp ________ ________

(Business Meeting & 1^st Raffle) Roosevelt Room

Thursday 30 Sept. Tour # 1 Murder-Mystery Dinner Show

$26.50/pp ________ ________

Pick up time at the hotel will be 6:00 P.M.

Friday 1 Oct. Tour #2 Southern Belle Riverboat Lunch/Cruise

Bus pick up time will be 10:45 A.M. (Buffet &2^nd Raffle) Imperial

Ballroom ,starting at 5:30 P.M. $26.50/pp . ________ _______

Saturday 3 October Photos & Banquet-Imperial Ballroom

Cash Bar at 6:00 PM .. Dinner at 7:00 P.M.

Annual Dues $10.00 Lifetime Dues $100.00 _________

Donation; _________

Reunion Book: $30.00 _________

TOTAL ________

Prices include Registration Fee,

Friday/Saturday meals and the Hospitality Room Goodies