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United Way Kick-Off Luncheon Ticket Order Form

Name:
Email address: business home
On behalf of Company (if applicable):
Phone:
Contact Name (if different than above):
Contact Phone (if different than above):
Number of seats ($20 Per Seat):
Number of tables ($160 Per Table - 8 seats):
 
Please Mail Tickets To  
Mailing Address:  
Postal Code:
 
Method of Payment  
Credit Card (call 757 5671 to complete the transaction)
Invoice (please fill in the values in this box only if paying by invoice)
Company (individual name if applicable):
Invoice Mailing Address:
Postal Code:
Phone:
Additional Information: