REGISTRATION FORM FOR BENOIT REUNION 2004
Please Note: Registration/Membership fee (if NOT already paid) __________ x $10.00 for an individual __________ x $15.00 for a family (living in the same household)
Name: __________________________________ Address: __________________________________________ Telephone Number: ____________________ Email address (if applicable) ____________________________ # of people attending (including children) ___________________________ Total amount enclosed: _________________________________ T-Shirts with our logo will be available to purchase at the reunion if you wish to buy them. |
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