2015 Meeting,

Middlebrooks Family Association, Inc.

October 1, 2, and 3, Vicksburg, Mississippi

 

Help with meeting planning by completing and returning this registration form;  please also consider including your 2016 dues at this time.

 

To make your Quality Inn reservation, call 601-636-0804 and mention the Middlebrooks Family Association. Room rates will be good until 9 September. See MFA Web site event announcement for room arrangements and their rates.

 

Name  (please print all information) ____________________________________

 

Address __________________________________________State __________

 

Phone __________________ E-mail __________________________________

 

For Name Tags:  Circle your ancestor: Joseph 1610,  Isaac 1753,  John 1754,  John 1755,  Micajah 1757, Sims 1762,  Thomas 1763,   Nathaniel 1764,  Robert 1766,  Joseph 1773,  Unknown,  Other ________

 

First name of each in your party  ___________________________________________________

 

Circle days attending:                      Thursday     Friday          Saturday 

 

Thursday lunch at motel (sandwiches, etc.)            # of people for lunch  ________

 

Thursday dinner (Toney's Steak and Sea Food)         # of people for dinner ________

 

Friday lunch (Walnut Hill Resturant)                           # of people for lunch  ________

 

Friday dinner (Rowdy's Steak and Sea Food)             # of people for dinner ________

 

Saturday lunch at motel (sandwiches, etc.)             # of people for lunch  ________

 

Saturday dinner (Amerstar Casino Buffet)                # of people for dinner ________

 

PLEASE NOTE:  Each person is to pay for their own meals

 

Registration fee:          $20 for paid member, including their family members

                                    $25 for non paid member, including their family members

Annual MDA dues       $20 for 2016 membership and pay the $20 registration

 

Make check payable to:  Middlebrooks Family Association, Inc.           Enclosed $ ______

 

Please mail registration form and check to:    Middlebrooks Family Association, Inc.

 

                                                                        C/O Kathleen Hunter

                                                                        P.O. Box 125

                                                                        Tupelo, AR 72169