William Penn Life, 2005 (40. évfolyam, 1-12. szám)
2005-04-01 / 4. szám
WILLIAM PENN ASSOCIATION Bowling Tournament Awards Dinner Reservation Form Holiday Inn, 17201 Northline Road, Southgate, Ml 48195 Saturday, May 28,2005/ Cash Bar 4:30 p.m./ Dinner 5:30 p.m. Please Print Please Print Please Print Contact Person Branch No. Phone No. Address City State Zip Names of Adults (Age 16 and Older) 1. Certificate Number 2. 3. 4. 5. 6. 7. 8. 9. 10. Names of Children Age 12-15 1. Age Certificate Number 2. 3. 4. Names of Children Age 0-11 1. Age Certificate Number 2. 3. 4. All adults and children will be served a buffet dinner. All adults and children will be served a buffet dinner. Number of Adults (Age 16 and Older) Number of Children Age 12-15 Number of Children Age 4-11 Number of Children Age 0-3 __x $21.00 =________ __x $11.00 =_________ __x $ 5.00 =________ __ FREE OF CHARGE TOTAL DUE = Request for Table of 10 __Yes No Reservations and Checks must be received by May 4, 2005 Make checks payable to: "William Penn Association" Mail completed reservation form and check to: William Penn Association, Attn: Richard W. Toth, 709 Brighton Road, Pittsburgh, PA 15233-1821 18 William Penn Life, April 2005
