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Reservation Form
Print this form and mail with your payment by July 7th to reserve your seat.

Please reserve _____ seats at the One Summer Night Oldies Dance Party at $25 each.
Enclosed is $_______.

I cannot attend but I enclose my contribution of $_____  which enters my name in a special drawing for a DVD player.  (All who donate $10 or more will be included in this special drawing.  You need not be present to win.)
 

Name:  ________________________________________

Address: _______________________________________

City: __________________________________ State:  __________Zip:________

Phone: ______________________________________

_____  Check enclosed (Make payable to One Summer Night)

_____  Credit Card:   ___ Visa    ___  MasterCard     ___ Amex       ___Discover

Credit Card # _______________________________

Exp Date: _____________________   Signature: _________________________

Name(s) of people attending: _________________________________________

________________________________________________________________

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