Registration Form

Cumberland District FUTIAWA Meeting
Clyde M. York 4-H Center, Crossville
Friday, May 8, 2009, 9:30 a.m., CDST

Please reserve lunch for ____ people x $15.00 each = __________

Name: ______________________________________________

Street: ______________________________________________

City, State, Zip: _______________________________________

Phone: ______-______-___________

Names of Guests:

__________________________________

__________________________________

__________________________________

Please print form, fill in necessary information, make check payable to FUTIAWA and mail by April 27 to:
Roger Thackston
2127 Ona Rd.
Crossville,TN 38572


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