registration form

Women Veterans Appreciation Banquet &
2015 Tri-State Women Veterans Lifetime Achievement Awards
On behalf of the Cincinnati VA Medical Center and the Cincinnati Education and
Research for Veteran (CERV) Foundation, we would like to extend to you this
special invitation to attend the 2015 Women Veterans Appreciation Banquet –
“Celebrating Women Veterans”. This is the one opportunity we have each year
to publicly honor and appreciate our women Veterans for their selfless and
dedicated service to the military and their community.
Date:
Thursday, June 11, 2015
Location:
National Underground Railroad Freedom Center
50 E. Freedom Way
Cincinnati, Ohio 45202
(Free parking at the Freedom Center)
Time:
6:00pm - 7:00pm Registration & Dinner
(Dinner salad, assorted bread, Tuscan Chicken topped with
tomato, mozzarella and parmesan, garlic mashed potato, seasonal
vegetable blend, dessert and beverage)
8:30pm - Awards Ceremony
Women Veterans:
Guest Registration Fee:
No Charge
$20.00 (Limit 1 guest per Woman Veteran)
Please publicize this important event and encourage Tri-State women Veterans to
attend. Applications for Women Veterans Lifetime Award nominees and register
to attend the event are available at the Women’s Health Center, Cincinnati VA
Medical Center or online at [email protected] and www.cervf.org,
Nominations must be submitted by close of business, May 11, 2015.
We encourage you to attend and submit nominations on behalf of a woman
Veteran who has displayed exemplary service and leadership while either serving
in the military, as a Veteran, or in her community. This award is part of the CERV
Foundations ongoing effort to lead and engage the Tri-State communities to
service Veterans, where they live and work.
This reservation form should be completed and mailed with $20.00 (for guest) by
close of business, Monday, May 31, 2015.
Women Veterans Appreciation Banquet &
2015 Tri-State Women Veteran Lifetime Achievement Awards
“Celebrating Women Veterans”
Thursday, June 11, 2015 at 6pm
National Underground Railroad Freedom Center
50 East Freedom Way
Cincinnati, Ohio 45202
(Free parking at the Freedom Center)
Name of Women Veteran: ______________________________________________
Name of Guest: ________________________________________________________
(Limit One Guest)
Amount Enclosed:__________ ($20.00 for Guest)
Email: _________________________________________________
Telephone Number: _____________________________________
Indicate Special Accommodations Needed: (Requests will be addressed on a case-bycase basis.)
______________________________________________________________________
Make checks or money orders payable to: CERV Foundation.
Please return this form and payment to the address below by close of business,
Monday, May 31, 2015 to:
Cincinnati VA Medical Center
3200 Vine Street, MD 151
Cincinnati, Ohio 45220