2009 REGISTRATION
Please
return this form by January 15, 2009.
(Please
print)
Name
_____________________________________________________________________________________
(Last) (First) (Middle) (Maiden)
Home Address
______________________________________________________________________________
(Street) (City)
(State) (Zip)
Home Telephone Number _( )_______________________
Cell Phone Number (
)________________________
E-mail Address ญญญญญญญญ__________________________________
In case we lose you, please give us the name, address and
telephone number of someone who will know how to contact you:
__________________________________________________________________________________________
Fees: I will be attending:
($50.00)
..
.
$_____________________
I will
bring my spouse or guest:
($50.00)
$_____________________
Name
of spouse/guest_____________________________
(Please indicate which)
I would
like an extra copy of the Tom Tom: ($15.00)
$_____________________
I
cannot attend but I would like a copy of the Tom Tom
mailed
to me: ($20.00)
...
$_____________________
I
would like to purchase yearbook advertising (or personal
message) Must be formatted and camera ready: Business card
($20.00)
.$_____________________
ผ page ($25.00)
.
$_____________________
ฝ
page ($50.00)
.$_____________________
full page
($100.00)
$_____________________
I
would like to make a contribution:
$_____________________
(Any amount will be appreciated!)
TOTAL:
.$_____________________
Please mark one:
Check is enclosed_______ I
will send my check by March 15th _______
Please make your check payable to: Tulsa Central Class of 1959 and mail
it with this form to
Mrs. Maggie (Margaret Will)
Cornell
2926 East
75th Court
Tulsa, OK
74136-5640
Questions? Contact
Karen Anderson Hughes at karenahughes@cox.net
or (918) 627-4086 or (918) 636-8150