REGISTRATION FORM

2018 NATIONAL WRESTLING HALL OF FAME WEST VIRGINIA CHAPTER BANQUET AND INDUCTION CEREMONIES Sunday, October 28, 2018 Embassy Suites, Charleston, West Virginia Social Hour 1:00 PM. Dinner served 1:45 PM, award presentation to follow

Congratulations to the 2018 Inductees John Geary Jim Issac Mike Litton Ray Marling Kim North Ray Pernell Gary Porter Chuck Satterfield John Staggers II

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BANQUET REGISTRATION
Purchase tickets by including payment with this form.
Price: $55.00 per person.
Make check payable to "West Virginia Chapter--National Wrestling Hall of Fame."
Deadline for ticket registration Monday October 22, 2018

Name_____________________________ Number of Guests:_______excluding self
Address___________________________________________________________
Telephone Number Home:________________ Work:____________________ Cell:_______________
email address: ________________________________________________
List guests names for name tags to be given out at the reception (Your name tags are your tickets.)
Your Name:________________________________________________
Guest Name:_________________________ Guest Name:_________________________
Guest Name:_________________________ Guest Name:_________________________
Guest Name:_________________________ Guest Name:_________________________

We are attending in honor of Recipient's Name__________________________________________________

Honorees' Special Contribution
Yes, I (we) want to honor (Honoree's Name): __________________
and support the National Wrestling Hall of Fame by sending a special contribution of:
_____$25 _____$50 _____$75 _____Other

This contribution is tax deductible.
Please write how you wish to have your name listed: _______________________

Return completed form to:

West Virginia Hall of Fame Chapter
150 Porterfield Lane
Beckley, West Virginia 25801