Number of people ____ X $28 per person = $ _______
(includes lawn seating and catered "plate lunch" dinner)
Tickets will be distributed during dinner at The Terrace
Number of people ____ X $10 per person = $ _______
(includes only "plate lunch" dinner; you buy your own tickets)
Please print your name, address, and telephone number:
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
Print this form
and send it with your check payable to UHAA-NCRC to:
Carita Tompkins, Treasurer, UHAA-NCRC
4418 Neptune Drive, Alexandria, VA 22309-3128
Please mail your payment before September 1, 2005
For additional information: e-mail CazimeroEvent@uhaa-ncrc.org
