PAYMENT10

To make payment, please complete this form, print it and send it with your check or money order, made payable ONLY to "Donald Sweeney"
Mr. Don Sweeney
12 Beech Street
P. O. Box 817
Point Lookout, NY 11569
The banks will not allow an alternative account without a Tax ID.

Personal Information
   Name at Graduation: Year Graduated:
   Married Name:
   Address
   Street:
   City: State: Zip Code:
   E-Mail Address:
   Home Phone:
Number Attending - Please check the appropriate box
   Solo: With Partner: Partner's Name:
Attending Which Functions
   Dinner / Dance:($85.00 Per Person) (Number attending)
   Brunch:($30.00) Per Person) (Number attending)
   Hotel Room Required? (Yes / No)
   Amount Enclosed $
Listings - Very Important - If left unanswered you will not be listed
   Post your E-Mail Address to the Alumni List? (Web Site) (Yes/No)
   PLEASE NOTE: ADDRESS DETAILS MAY BE PUBLISHED IN A REUNION BOOK FOR DISTRIBUTION
   TO ATTENDEES. PLEASE INDICATE IF YOU WANT TO HAVE YOUR DETAILS LISTED. (Yes/No)
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