Post Office Box 2886
Bala Cynwyd, PA 19004
| Member* | $80.00 x _____ = |
$ ________ |
| Non-members | $95.00 x _____ = |
$ ________ |
| Tables of 10 | $950.00 x _____ = |
$ ________ |
| Additional Gift | $ ________ | |
Total Enclosed: |
$ ________ |
*The Member price is available to Members only. Non-member guests of members pay the Non-member price.
PLEASE MAKE YOUR CHECK PAYABLE TO:
BROADCAST PIONEERS OF PHILADELPHIA
Name ______________________________________________
Address ____________________________________________
____________________________________________________
Telephone ___________________________________________
Guests_______________________________________________
_____________________________________________________
_____________________________________________________
Your canceled check is your receipt. Your placecard(s) will be available at the door. No tickets will be mailed.
Post Office Box 2886
Bala Cynwyd, PA 19004