ON-LINE REGISTRATION FORM
YOUR INFORMATION
Last:
First:
MI:
Rank:
Branch:
Army
Air
Desired Name on Name Tag?
Do you have Profession Development Orders?
Yes
/
No
CONFERENCE INFORMATION
Friday Lunch
Saturday Lunch
Lunches are $10 each day
No charge if on PD Orders
Banquet Choice
(Must Pay, Not part of PDW)
NONE
TOP SIRLOIN STEAK
CHICKEN CREM DE CHARDONNAY
FILET OF WALLEYE PIKE
JUMBO SHRIMP
BOURSIN CHEESE MANICOTTI (VEGETARIAN)
Banquet Cost is $25.00
SPOUSE or GUEST INFORMATION
(If also in the Military please fill out a separate form)
Last Name:
First Name:
Desired Name on Name Tag:
Friday Lunch
Saturday Lunch
Lunches are $10 each day
No charge if on PD Orders
Banquet Choice
(Must Pay, Not part of PDW)
NONE
TOP SIRLOIN STEAK
CHICKEN CREM DE CHARDONNAY
FILET OF WALLEYE PIKE
JUMBO SHRIMP
BOURSIN CHEESE MANICOTTI (VEGETARIAN)
Banquet Cost is $25.00
NOTE: Click the submit button below to finalize the registration process. You can then pay for your meals using the "On-Line Meals Payment" links below.