HIRSCH CLASS REUNION DEPOSIT SLIP

**PLEASE PRINT CLEARLY**

     GRADUATION YEAR  ___________

     FIRST NAME  _____________________________ 

     LAST NAME  _______________________________

     MAIDEN NAME  _______________________________

     MAILING ADDRESS  ______________________________________

     CITY__________________   STATE______    ZIP________

     PHONE  (________)  ________-______________

     EMAIL ADDRESS____________________@_____________._____

 

    GUEST LIST: (Please include first & last name of each guest)

                             1.________________________________________________________

                             2.________________________________________________________

                            3.________________________________________________________

 

                             $35.00 x __________ alumni(s) = $_________

                            $35.00 x __________ guest(s) = $ _________

                                                               TOTAL    $ ___________

                                                                                                     

                                                                  PAYMENT TYPE:

                                                                                        PERSONAL CHECK

                                                                                        MONEY ORDER

                                                                                        CASHIERS CHECK

                                                                                        CASH*

     *ALL CASH PAYMENTS MUST BE MADE IN PERSON ONLY, DO NOT MAIL CASH

 

~REMEMBER THAT ALL DEPOSITS ARE NON-REFUNDABLE~

 

~ALL PAYMENTS CAN BE MADE TO: HIRSCH CLASS REUNION

~MAIL ALL PAYMENTS TO:  HIRSCH CLASS REUNION

                                               P.O. BOX 428146

                                               EVERGREEN PARK, IL 60805