2012 Reunion Registration

NAME____________________________________________ DATE______________

ADDRESS:_________________________________________

City State Zip:_________________________________________

TELEPHONE# Include Area Code_______________________

EMAIL:___________________________

Select all that apply, this is per person attending:

_______Registration fee (includes Group Dinner Friday Night)

2011 reunion shirts are available in gray and sand. Reunion Shirt with 5^th Maintenance Crest on back and over pocket area with Reunion 2012 and your first name on the front and your unit (s) on the back. See sample on 5^th WEB site or Facebook site.

S,M,L    $20

XL and XXL $22

Name on shirt________________                                         

Unit or Units___________________________________

Add $4.95 shipping for one shirt, $10.70 for 2 or as many as we can stuff in the larger box.

Make checks payable to 5th Maintenance Battalion
Send To: Mr. Ken Hamblin
5th Maintenance Battalion
59 North 2120 East Circle
St. George, UT, 84790