Paramedic Trainee Sponsorship Request

To honor the “Guys in Back” – the DUSTOFF Association is honoring the new Flight Medics in training at the University of Health Sciences Paramedic Training Program. Limited numbers of sponsorships are being provided by members of the DUSTOFF Association. These will be provided on a “first come – first served” basis. You will be notified of your approval to attend the Saturday, April 1, 2017, DUSTOFF Awards Banquet. Uniforms are NOT required. Please provide us with the following information and we will contact you about your selection/non-selection (space restricted).

Rank:

Name:

Street Address:

Street Address 2:

City:

State:

Postal/ZIP Code:

Home Phone:

Your E-mail:

Paramedic Class Number:

Spouse/Guest Name at $45 each to be collected at the Reunion:

Dinner Entree Selection: Number
     Brie and Apple Stuff Chicken
     Fire Grilled Sirloin
     Veggie Meal