PRINT THIS FORM, FILL IT OUT AND SEND IT TO:
The Survivors c/o Karen DeWall
3979 Bridle Path Loop,
Pinetop, AZ 85935
Yes, I'll be attending the Media and Advertising Survivors Annual Reunion, Saturday,
April 28, 2018, 12 Noon, at the Arcadia Tavern.
List yourself, those coming with you, and meal choice of chicken or salmon.
Name____________________________________________Chicken___Salmon___
Name____________________________________________Chicken___Salmon___
Name____________________________________________Chicken___Salmon___
Name____________________________________________Chicken___Salmon___
Enclose a check to The Survivors for a total of $25 times the number of your attendees.
Thank you, and we look forward to seeing you!!
To keep our records up to date for future contact, please give us your current information. (We never share this with anyone)
Name_______________________________________________
Address_____________________________________________
City____________________State________Zip______________
e-mail address:________________________________________
