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ALL REGISTRATIONS DUE BY AUGUST 8th.

_____ Please make reservations for _______ (# attending) at $35 per person.
_____ Please reserve a table for 10 for $350
_____ Please reserve a half table for 5 for $175

I’d like to pay by: ____ Check Enclosed ____ Debit/Credit Card *(see below) ____ Bill Me
{Please make checks payable to the United Way of West Alabama.}

Name ______________________________________

Business ____________________________________

Phone ______________________________

Email _______________________________________________

Address _________________________________________________________________

City __________________________________

State ________________________

Zip___________________

*If paying by Debit/Credit Card: Name on Card
________________________________________________

Debit/Credit Card # _______________________________________

Exp _______________ Zip ___________

downloadable PDF:
2017 Kickoff Luncheon flyer