Fairfax Federation Citizen of the Year Banquet RSVP

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Fairfax Federation Citizen of the Year Banquet RSVP for 7 May 2023
To pay for your reservation, please either use the PayPal button below or mail a copy of this printed form with a check made payable to FCFCA to:

THE FEDERATION
Attention: Citizen of the Year Banquet
P.O. Box 3913
Merrifield, VA 22116-3913

Please enter your information below, print out a copy for your records (landscape mode) and then click the SUBMIT button below to submit your reservation form.

Submitter: Email address: Phone Number:
Company or Organization: Address:
Attendees/Cost	Name	Dinner Choices: (Please indicate a meal choice for each attendee)
1 $ 65			Chicken Salmon Vegetarian
2 $130		Chicken Salmon Vegetarian
3 $195		Chicken Salmon Vegetarian
4 $260		Chicken Salmon Vegetarian
5 $325		Chicken Salmon Vegetarian
6 $390		Chicken Salmon Vegetarian
7 $455		Chicken Salmon Vegetarian
8 $520		Chicken Salmon Vegetarian
9 $585		Chicken Salmon Vegetarian
10 $650		Chicken Salmon Vegetarian

1. With which honoree's group would you prefer to be seated? Marco Johnson Paula Lettice John Litzenberger, Jr Michele Menapace Linda Moore Peter F. Murphy Federation Other No preference

2. I am unable to attend however I wish to help defray the Fairfax County Citizen of the Year Awards Banquet in the amount of: $

3. Opportunities to be a sponsor of the Fairfax County Citizen of the Year Awards Banquet are explained here.

4. If paying by check, please mail a copy of this printed form with your check made payable to FCFCA to THE FEDERATION, Attention: Citizen of the Year Banquet, P.O. Box 3913, Merrifield, VA 22116-3913.

5. If you are completing this form after 2 May, do not mail a check, instead pay using PayPal below. After submitting your reservation electronically, please call 703-424-2956 to confirm your reservation (Payments cannot be accepted at the banquet).

6. Tickets will be held at door.

Please print this page landscape mode using your printer's properties box before submitting

Click here to pay by

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