US Colored Troops Living History Association
2009 Registration Form

October 16-18, 2009

Ramada Inn

2143 N. Broadway

Lexington, KY 

Registration

 

Name: ______________________________________-Title:-____________________________________________

 

Organization/Unit: _____________________________________________________________________________

 

Address:_____________________________________________________________________________________

 

City _____________________________ State:____________ Zipcode: ____________________________

 

Telephone: _________________________ Fax: _________________________________________

 

Email: ___________________________________ Website:_____________________________________

 

Registration : $55 ___ (Includes Friday Reception, Saturday Luncheon & Saturday BBQ)_________________

                Guest: $45 ___

 

Ramada Room Reservations: 800-2-RAMADA– Room Rate: $89 + tax before 10/2/09

 

Type of payment:                __________ Check                           ___________ Credit Card

 

Credit Card:  ________  Visa                ________  MC                  

 

Name:  __________________________________                Signature:  ___________________________

 

Credit Card #:  ___________________________                 Expiration Date:  ______________________

 

Company:  ____________________________________________________________________________________

 

Address:  _____________________________________________________________________________________ 

 

City __________________________________ State _____________ Zipcode ______________________________

 

Phone (         )  ________________________________                            Fax (      )  ___________________________

 

Email:  _______________________________________________________________________________________ 

 

Email: beecheagle@gmail.com

Make checks payable to:

USCTLHA
Tel. 866-99-32453    PO Box 116 
    Kensington, MD 20895

                                                                                                     

 

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