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Fairfax Federation Citizen of the Year Banquet RSVP for 3 April 2016
To pay for your reservation, please either use the PayPal button below or mail a copy of this printed form with a check made payable to FCFCA to:
THE FEDERATION
Attention: Citizen of the Year Banquet
P.O. Box 3913
Merrifield, VA 22116-3913
Please enter your information below, print out a copy for your records (landscape mode) and then click the SUBMIT button below to submit your reservation form.
  Submitter:  Email address:  Phone Number: 
  Company/Affiliation Address
Attendees/Cost Name Dinner Choices:
1 $ 65 Chicken Salmon Vegetarian
2 $130 Chicken Salmon Vegetarian
3 $195 Chicken Salmon Vegetarian
4 $260 Chicken Salmon Vegetarian
5 $325 Chicken Salmon Vegetarian
6 $390 Chicken Salmon Vegetarian
7 $455 Chicken Salmon Vegetarian
8 $520 Chicken Salmon Vegetarian
9 $585 Chicken Salmon Vegetarian
10 $650 Chicken Salmon Vegetarian
 1. With which recipient's group would you prefer to be seated? Olga Hernandez Doug Sanderson Jim Hart Phil Rosenthal Sally Sibley Shirley Ginwright Other No affinity
 2. I am unable to attend however I wish to help defray the Fairfax County Citizen of the Year Awards Banquet in the amount of: $
 3. Opportunities to be a sponsor of the Fairfax County Citizen of the Year Awards Banquet are explained here.
 4. If paying by check, please mail a copy of the printed form with your check made payable to FCFCA to THE FEDERATION, Attention: Citizen of the Year Banquet, P.O. Box 3913, Merrifield, VA 22116-3913.
 5. If you are completing this form after 30 March, do not mail a check, instead pay using PayPal below. After submitting your reservation electronically, please call 703-424-2956 to confirm your reservation (Payments cannot be accepted at the banquet).
 6. Tickets will be held at door.
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Fairfax County Federation of Citizens Associations, P.O. Box 3913, Merrifield, VA 22116-3913
2005 - FCFCA;
http://www.FairfaxFederation.org FedWebmaster2016%20@%20fairfaxfederation.org