2012 Basket Ball

First Name
Last Name
Company Name
Address
City
State
Zip
Phone Number	HomeWork
Email

If you have any questions please contact us:

E-mail: janek@jimboeheim.com

Phone:
315-443-1877
877-219-4141

Indicate how many seats or tables you would like to reserve. After choosing the quantity you will be able to enter the names of the individuals attending the Basket Ball.

seats @ $300 each	$
tables for 10 @ $3000 each	$


I would like to place our company logo at our table for $ 100 Yes No
I would like to place an add in the program book (you will contacted with aditional information) $300 (full page) $200 (half page) $100 (quarter page) No Ad
I am unable to attend, but have enclosed a donation of	$

Note: The cost of each reservation, less $100 is tax deductible.

RSVP by APRIL 13, 2012
Questions, Call Jane Klucsik at 315-443-1877 or 1-877-219-4141