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