Mechanicsburg Alumni Association – Dues & Annual Meeting Reservations
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1. Membership Dues     #_________ @ $10.00...............................$___________

2. Dinner Reservations #_________ @ $30.00...............................$___________

   #______ Stuffed Pork Tenderloin        

   #______ Chicken Cordon Bleu, stuffed with ham and cheese
       
       SPECIAL MEAL NEEDS____________________________________________________________
     

3. Administrative Fund.......$___________      4. Scholarship Fund.......$___________

      This donation is in    ____honor of       _____memory of:

      NAME_____________________________________________________ CLASS YEAR___________


      On the occasion of ____________________________________________________________
                            (Birthday, Anniversary, Class Reunion, etc.)


      Please notify the following of this contribution:

      NAME________________________________________________________________________

      ADDRESS_____________________________________________________________________

      CITY___________________________________________ STATE_______ ZIP____________



5. The Wildcat Foundation................................................$___________


6. TOTAL ENCLOSED........................................................$___________

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YOUR NAME _____________________________________________________________ CLASS__________
                (Include maiden name when appropriate.)


ADDRESS________________________________________________________________________________


CITY_____________________________________________  STATE_________  ZIP_________________


PHONE____________________________  E-MAIL______________________________________________


SPOUSE/DINNER GUEST's NAME_____________________________________________________________

Please make check payable to: MAHSAA

Please mail this complete form with your check to:
Gladys S. Ritter, 712 S. Market Street, Mechanicsburg, PA 17055

Dues and contributions are tax deductible
THANK YOU FOR YOUR DONATION!