ALUMNI BANQUET DINNER AND/OR DUES RESERVATION FORM

 
ALUMNI BANQUET DINNER AND/OR DUES RESERVATION FORM
RESERVATION DEADLINE is JUNE 11, 2010  
 
Member 1 Name:___________________________  Class of:: ________________________
 
Member 2 Name:___________________________  Class of:: ________________________
 
Address ________________________________      Guest Name: ________________________
 
              ________________________________      Guest Name:________________________
 
_____ 8 oz. Prime Rib slow roasted & served with a baked potato
                                                                 x         $25.00  = $________ (member, includes dues and meal)
 
_____ 8 oz. Prime Rib slow roasted & served with a baked potato
                                                                 x         $20.00 = $________  (non-member only, includes meal)
 
_____ Baked Stuffed Chicken Breast with stuffing & chicken gravy; served with red skinned mashed potato
                 x         $25.00 = $_______(member, includes dues, and meal)
 
_____ Baked Stuffed Chicken Breast with stuffing & chicken gravy; served with red skinned mashed potato
     x        $20.00 = $_______(non-member only, includes meal)

_____ Atlantic Haddock fillet broiled with lemon butter & white wine; served with rice pilaf
                                                                 x        $25.00  = $________ (member, includes dues and meal)
 
_____ Atlantic Haddock fillet broiled with lemon butter & white wine; served with rice pilaf
                                                                 x        $20.00 = $________  (non-member only, includes meal)
 
  You may deduct $2 from these costs IF you have provided your email address so we may send your newsletter to you through email rather than through US Postal Service.
Email address:_____________________________    minus $2.00      - $__________________
 
TOTAL ENCLOSED $________ (total of all reservations, minus any applicable discount)
 
_______ Sorry, I cannot attend but I would like to continue my membership and receive the newsletter and help with the annual Alumni Gift to the school.  My $5 membership fee or $3 membership fee (provide email address ___________________________________________) for the 2009-2010 year is enclosed.

Send Reservations and Payment To:
Willsboro Alumni Association
Shirley Phillips, Treasurer
PO Box 211
Willsboro, NY   12996-0211




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