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ASSESSMENT AND T-SHIRT ORDER FORM |
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Adult Assessments $99.00
Name of Family Member: --------------------------- --------------------- --------------------------- ------ --------------- CHILDREN 1-5 FREE ------------------- ---------------------- -------------------- ---------------------- Total Assessment Amount:_______________ T-Shirts: Adults $12.00 #_____ & size__________ Children $10.00 #_____ & size__________ Total T-Shirt Amount:_____________ Total assessment and T-shirt amount enclosed:_______________ Make check or money order payable to: LAWRENCE SPRUILL REUNION LA. Mail payments as soon as possible to: Inoler H. Brown 19402 Belshaw Ave. Carson, CA 90746 |