Souvenir Program
Place an X in the box for each service award category you qualify for and wish to be listed.
Legacy members: Provide information for each legacy member and include the relationship: Father/Son/Grandfather
($10.00 for each name listed)

Patron Names

Completed form must be received by March 10, 2018.
All checks or money orders are to be made payable to “2018 Third District Planning Committee” Please return the Order Form and Payment to : 2018 Third District Planning Committee, PO Box 9228, Hampton, VA 23670.