25th CELEBRATION DINNER TICKET PURCHASE FORM

1
Yes! Ill be attending ISA-SSJVs 25th Year
Celebration at Luigis Italian Restaurant!

• 25th CELEBRATION DINNER TICKET PURCHASE FORM
• Name _____________________________ Phone
  ______________________
• Email Address ________________________________
• ( ) Yes, Ill be there! (Cost is 20.00 per
  person, 40.00 per couple)
• Name of Spouse or Significant Other
  _________________________________
• Number of Banquet Reservations Qty
  _______ TOTAL __________
• Make check payable to ISA-SSJV
• Or
• Provide Credit Card Information
• Credit Card Number ______-______-______-______
• Master Card of Visa only ( ) MC ( ) Visa
• Expiration Date ___/___ Card Holder
  ______________________
• (A receipt will be returned by email)
• Mail by snail mail to arrive by 9/15
• ISA-SSJV