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Fairfax Federation 2013 Citizen of the Year Banquet RSVP for 27 April 2014
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 Sirloin Salmon Vegetarian
2 $130 Sirloin Salmon Vegetarian
3 $195 Sirloin Salmon Vegetarian
4 $260 Sirloin Salmon Vegetarian
5 $325 Sirloin Salmon Vegetarian
6 $390 Sirloin Salmon Vegetarian
7 $455 Sirloin Salmon Vegetarian
8 $520 Sirloin Salmon Vegetarian
9 $585 Sirloin Salmon Vegetarian
10 $650 Sirloin Salmon Vegetarian
 1. With which recipient's group would you prefer to be seated? Janyce Hedetniemi Tena Bluhm Kathy Kaplan Jim Moran Jim Scott Frank Wolf 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 April 21st, do not mail your check. After submitting your reservation electronically, please call 703-489-5999 to confirm your reservation and then pay at the banquet registration desk (credit cards can 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 FedWebmaster2015%20@%20fairfaxfederation.org