Pre-Convention Registration
Please read:
The top form is for ADBC Members (former POWs) and persons
accompanying them. All others use the second form. Submit completed forms:
by U.S. Mail to: John B. Lewis
Or by E-mail to:
16415 Jersey Drive
redlegs6@comcast.net
Jersey Village, TX 77040-2021
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ADBC MEMBER - REGISTRATION CARD
First Name:_________________________ M.I.: ______ Last Name:
____________________________________
Nickname: (Submit if you want it on Name Tag)
______________________________________________________
Street (or P.O. Box):
__________________________________________________________________________
City: ______________________________________________ State:_________ ZIP:
_______________________
Phone #: (_______) _____________________________ Attend Banquet Saturday
night? (Yes or No) ___________
E-mail address:
______________________________________________________________________________
Your Unit in the P.I.:
__________________________________________________________________________
Name of ONE POW Camp to go on Name Tag:
_____________________________________________________
List of persons accompanying the member:
Full Name
Relationship
Attend Banquet Saturday night? (Yes or No)
_______________________________________
___________
_____________
_______________________________________
___________
_____________
_______________________________________
___________
_____________
_______________________________________
___________
_____________
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Non-MEMBER - REGISTRATION CARD
First Name:__________________________ M.I.: ______ Last Name:
___________________________________
Street (or P.O. Box):
__________________________________________________________________________
City: ________________________________________ State:______________ ZIP:
_______________________
Phone #: (_______) ___________________________ Attend Banquet Saturday night?
(Yes or No) ___________
E-mail Address:
______________________________________________________________________________
Full Name of former POW Relative/friend:
_________________________________________________________
Your relationship to the former POW:
_____________________________________________________________
The former POW’s Unit in the P.I.:
_______________________________________________________________
List of persons attending with you:
Full Name
Relationship to you Attend
Banquet Saturday night? (Yes or No)
______________________________________ ___________
_____________
______________________________________ ___________
_____________
______________________________________ ___________
_____________
______________________________________ ___________
_____________
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