| Name: | ____________________________________________________________ | |
| Address: | ____________________________________________________________ | |
| Telephone: | _____________________________ | |
| _________ | Yes, I do plan on attending: $60.00 | |
| _________ | Yes, I will be attending along with my spouse/date: $120.00 | |
| _________ | No, I do not plan to attend. | |
| T-shirts and Caps | ||
| _________ | Yes, I would like to purchase a T-shirt ___ Qty X $8.00 = _____ (Please include $1.00 for each "X" size.) | |
| _________ | Please give T-shirt sizes (S, M, L, XL, 2XL). | |
| _________ | No, I would not like to purchase a T-shirt. | |
| _________ | Yes, I would like to purchase a cap ___ Qty X $4.50 = _____ | |
| _________ | No, I would not like to purchase a cap. | |
| Advertisement for Souvenir Booklet | ||
| _________ | Yes, I would like to purchase an ad in the Souvenir Booklet. | |
| _____$100.00 | - Full Page Ad | |
| _____$60.00 | - Half Page Ad | |
| _____$40.00 | - Quarter Page Ad | |
| _____ $5.00 | - Patrons List | |
Reminder: Please attach a separate page with information you wish to appear in your | ||
Please Mail This Form To: | ||
| Dorothy Jenkins, Treasurer Carver-Stephens School Reunion 4747 Highway 79 South Stephens, AR 71764-9236 Phone: 870-786-5019 | ||
| Signature: | ________________________________ | Date: | ____________________ |