23rd Union Pre-registration Form

23rd Union – Melungeon Heritage Association
Wytheville, Virginia
June 20, 21, and 22, 2019

(Registration Deadline: June 14, 2019)

The fee is $10 for any or all of the days, Thursday, June 20; Friday, June 21; and Saturday, June 22, 2019. PLEASE EMAIL COMPLETED FORMS TO MHAinc2000@yahoo.com OR SEND TO Melungeon Heritage Association, Inc., PO Box 4063, Barboursville, WV 25504 **For MHA planning purposes, please indicate whether you are attending the Edith Bolling Wilson Tour on Thursday, June 20; the Burke’s Garden Tour and lunch at Your Grate Escape, Friday, June 21; and the reception, Friday evening, June 21.**

(All fees will be payable at the door when you sign in for the 23rd Union at the Bolling Wilson Hotel Lobby or Wytheville Meeting Center)

Please register below Copy this form for additional registrations.

Will be Attending

Name: _________________________________________________________

Address: _______________________________________________________

Email address___________________________________________________

Check here if you plan to tour the Edith Bolling Wilson Museum at 3 p. m. on Thurs., June 20 ________
Check here if you plan to tour Burke’s Garden & eat at Your Grate Escape on Friday, June 21. _______
Check here if you plan to attend the Friday evening reception, Bolling Wilson Hotel at 7 p. m. _______
\_______________________________________ Email


I wish to make a contribution to MHA

In Memory/Honor of____________________________________________

Enclosed is my check/money order for $___________


Thank You for Supporting MHA

Send the completed form for those attending to: or complete and email the form as an attachment to mhainc2000@yahoo.com

For any questions please contact: Lynda Davis-Logan at WHATCHANOJOE@hotmail.com or Scott Withrow at MHAinc2000@yahoo.com