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Please complete all blanks and print very clearly to prevent errors. Applications may be mailed to:

USTJF National Office
PO Box 8520
Waukegan, IL 60079

Please print this from, fill it out, and mail it to the above address with the required fees. (Enrollments are limited.)

Name		Age	Rank
Address		City	State	Zip
Phone	Cell	Fax
Email
School/Department/ Company Name
Address		City	State	Zip
Phone	Cell	Fax
Email
Attached is payment for _____ person(s), attending the ______________Program.
Total amount enclosed: $______________
Remarks:
Price schedule for the Fifth Annual Gathering of Warriors: Before 7/01/10 At Door USTJF Members* Any 1 Session $40.00 $50.00 $35.00 Any 2 Sessions 70.00 80.00  60.00 Any 3 Sessions 90.00 100.00 75.00 Click here to register for membership in the USTJF