1965-1969 Alumni Reunion Registration Form

1965-1969
alumni reunion

(Please complete entire form. • Photo copies accepted. • Please print.)

Name ______________________________________________

Address _______________________________________________________________

City __________________________________ State ___________ Zip _____________

Phone (______)_____________ Email ________________________________________

$40 Early Registration (postmarked by April 30, 2008) Includes Wednesday’s breakfast, lunch, and banquet as well as breakfast on Thursday	$____________
$45 Postmarked in February (postmarked in May, 2008)	$____________
OTHER EVENTS REQUIRING ADVANCE RESERVATIONS:
Tuesday, May 20 ___ # $40/person Historic Dinner Train (Abilene, KS) ___ # $10/person Housing in MCC Kenoyer Hall	$____________ $____________
Wednesday, May 21 ___ # $10/person Housing in MCC Kenoyer Hall	$____________
Thursday, May 22 ___ # $35/person Golf at Colbert Hills	$____________

PAYMENT OPTIONS: Check or Credit Card
TOTAL For Registration	......	CHECK ENCLOSED	$________
Make checks payable to MCC and mail with registration form to MCC, Alumni Reunion 65-69, 1415 Anderson Ave., Manhattan, KS 66502
TOTAL For Registration	......	BILL MY CREDIT CARD FOR	$________

Master Card VISA -- Expiration Date ___________

Name on Card __________________________________

Card Number ___________________________________

Credit Card Security Code Number: _________ (3 or 4 digit number on the back of the card)

Daytime Phone (_______) _________________________

Signature ______________________________________