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IMPERIAL REPRESENTATIVE LADIES LUNCHEON Ticket Order Form (Additional Tickets) PLEASE RETURN THIS FORM WITH PAYMENT TEMPLE NAME: ____________________________________________ CONTACT: ________________________________________________ MAILING ADDRESS:_________________________________________ _________________________________________ Enclosed is payment for the following, Tickets for the 2004 Imperial Ladies Luncheon at $50 00 each (US Funds) (Number)_________ @ $50.00 Total Amount Enclosed $____________ (Check or Money Order Only - Drawn on a US Bank) Your Cancelled Check is your Receipt. Make check or money order payable to. Imperial Council Session 2004, Inc. Mail form and check to: Imperial Council Session 2004, Inc No refunds after June 1, 2004 Your exchange coupons will be available at the
"Gift Exchange" window during Please provide the name of the individual who will be authorized to pick-up these exchange coupons. We will require an ID before releasing the coupons. Exchange Coupons will be picked up by: ____________________________________ |
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