SAR Citizenship Student Nominee and Awards Luncheon Reservation Form

SAR Citizenship Student Nominee and Awards Luncheon Reservation Form

Please fill out all required details accurately to ensure proper recognition and reservation.
General Joseph Bartholomew Chapter of the Sons of the American Revolution
Outstanding Citizenship Program
Recognizing High School Seniors from McLean and Woodford Counties
Please note: Student nominees must complete the online application form and upload the required PDF documents and photo as well as using the reservation form below for the Awards Luncheon.
Nominee Name (enter exactly as it will appear on the certificate)*

First NameMiddle NameLast Name
School Name*
Nominee Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
RESERVATIONS for the GJBSAR Awards Luncheon
11:20 AM, April 9th, 2026
Bloomington Country Club, 605 Towanda Ave
Bloomington, IL 61701.
Number of Reservations for the Nominee*
GJBSAR will provide lunch for the nominee and up to two parents/guardians without charge. The count should include the nominee (maximum of 3).
Nominee Name*
Parent/Guardian 1
Parent/Guardian 2
Additional Reservations may be included at the cost of $37.00 each.
School Representative Name & Title (at $37.00 each)
Guest Name (at $37.00 each)
Guest Name (at $37.00 each)
Credit Card (please use the form below)Check (please mail the check--payable to GJBSAR--to Mr. Robert Jones, GJBSAR Treasurer, 2911 Dodge Drive, Bloomington, IL 61704)

CREDIT CARD PAYMENT FORM

Additional Guest at $37.00

$37.00 Quantity

Total

$0.00