ASSESSMENT AND T-SHIRT ORDER FORM

Names of Family Members

Adults 13 and older - $80.00

______________________________   ____________________________

______________________________    ___________________________

Children 5 -12 - $35.00

_____________________________       ___________________________

_____________________________        ___________________________

Children 4 and under – FREE

________________________                     ___________________________

__________________________                 ___________________________

Total Assessment Amount: _________________

T-Shirts: Adult sizes: $12.00 – Children sizes: $8.00. Please, put the quantity for each desired size.

Adult: S_____ M_____ L_____ XL_____ 2X_____ 3X_____ 4X_____

Child: S(8-10)_____ M(10-12)_____ L(14-16)_____ XL(16-18)______

                                            Total T-Shirt Amount :______________
 

Total Assessment & T-Shirt Amount Enclosed :   ___________

Make checks or money orders payable to: Lawrence-Spruill Reunion

Mail payments as soon as possible to: