Please mail U. S. Postal Money Order or Cashier’s Check payable to Jennifer A. Grant along with the completed form to:
Jennifer A. Grant
8560 SW 166 Street
Palmetto Bay, FL 33157
PLEASE PRINT OR TYPE
Name ____________________________________________ Maiden Name _____________________
Mailing Address______________________ City__________________ State_______ Zip Code_________
Email Address______________________________________________
Cell Phone _________________________
Tickets are $100 per person and due no later than October 16, 2019. Please include Guest name(s) including maiden name.
1. Guest Name ________________________________________
2. Guest Name ________________________________________
3. Guest Name ________________________________________
4. Guest Name ________________________________________
5. Guest Name ________________________________________
6. Guest Name ________________________________________
Amount of Payment = $____________
*ALL PAYMENTS ARE NON-REFUNDABLE*
___ I will not be able to attend the Class Reunion but would like to be added to the distribution list to receive future Class correspondence. (Form can be emailed to jgrant56@bellsouth.net if not attending)