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2010 Centennial Banquet ticket request:

Tickets will not be mailed. They will be available for pickup as stated on the banquet page.

Make your check payable and mailed to:

Friends of Proviso East

PO Box 5029

River  Forest, IL 60305-5029

Please check which option you are ordering:

____ One Person - $65

____ One Person with Memory Book - $100

____ Two Persons - $130

____ Two persons with 1 Memory Book - $165

____ Two Persons with 2 Memory Books - $200

PLEASE PRINT ALL INFORMATION LEGIBLY

Class Year(s) __________


Class Last Name(s) __________________________________________________________________________


Current Name(s) _____________________________________________________________________________


Address: ___________________________________________________________________________________


City _______________________________________________________________________________________


State _________________________________________ Zip __________________________________________


Phone _____________________________________________________________________________________


Comments: _________________________________________________________________________________


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