NUMBER OF TICKETS
@ $30 Each =
Boosters List my name(s) in Journal as follows*
EXAMPLE: John and Jane Doe; Dr. & Mrs. Mark Evans; The Smith Family
List my name(s) in
Journal as follows*
MEMORY OF OUR FORMER DIRECTORS:
publication in the Ad Journal, donations must be
received no later than September 27, 2002.
DOLLAR AMOUNTS 0.00 TOTAL =
/ LAST NAME
STATE / ZIP CODE
METHOD OF PAYMENT:
EXP DATE: 00 / 0000
DIFFERENT THAN ABOVE, PLEASE ENTER THE NAME AND ADDRESS EXACTLY AS IT APPEARS
ON YOUR CREDIT CARD STATEMENT
MAILING OR FAXING, PLEASE INCLUDE CARDHOLDERS SIGNATURE
NOTICE: Submitting this form by clicking on the
submit bar sends your order in a non-encrypted format, which is only as
secure as email transmissions.
In addition to submitting your order online, you
have the option of mailing, faxing or calling-in your order. Submission via Internet is at your own risk.