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Events The Good Samaritan Fund The Founders Club Race/Walk for the Ages
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The 2007 Founders Club Dinner

Registration Form

Name *
Organization
(if applicable)
Address *
City * State * Zip *
Telephone
Email *

I/we will support the 2007 Founders Club Project as:
Benefactor at $300 (includes Founders Club membership, 2 tickets to the dinner, and special recognition in the dinner program)
Founder at $99 (includes Founders Club membership, 1 ticket to the dinner, and special recognition in the dinner program)
Associate at $75 (includes Founders Club membership and 1 ticket to the dinner)
   

I/we plan to attend the 2007 dinner.
Number of people attending
Meal choice preference:
Roasted pork loin, sweet potato hash, sugar snap peas
Chicken breast, whipped potatoes, green beans
I/we will NOT attend the dinner but are making my/our contribution of support at this time for the 2007 Founders Club Project.
* required

 

 
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