ALUMNI BANQUET DINNER AND/OR DUES RESERVATION FORM
RESERVATION DEADLINE is JUNE 10, 2011
The banquet date is Saturday, June 25, 2011. There will be a social hour
beginning at 3pm with introductions and dinner at 5pm
When completing the form, please print
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 $30.00 = $________ (member, includes dues and meal)
_____ 8 oz. Prime Rib slow roasted & served with a baked potato
x $20.00 = $________ (non-member only, includes meal)
(must be accompanied by a member)
_____ Baked Stuffed Chicken Breast with stuffing & chicken gravy; served with red skinned mashed potato
x $30.00 = $_______(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)
(must be accompanied by a member)
_____ Atlantic Haddock fillet broiled with lemon butter & white wine; served with rice pilaf
x $30.00 = $________ (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)
(must be accompanied by a member)
TOTAL ENCLOSED $________
_______ 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 $10 membership fee for the 2011-2012 year is enclosed.
Send Reservations and Payment To:
Willsboro Alumni Association
Shirley Phillips, Treasurer
PO Box 211
Willsboro, NY 12996-0211