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Registration
Form
Western
District FUTIAWA Meeting
West
Tennessee Research and Education Center, Jackson
Wednesday, April 22, 2009
9:30 a.m., CDST for coffee and visiting with other retirees
Program begins at 10:00 a.m. in Assembly Room B
Please
reserve lunch for _____ people x $10.50 each = $___________
Name: _______________________________________________
Street: ______________________________________________
City,
State, Zip: ________________________________________
Phone:
______-______-___________
Names
of Guests:
__________________________________
__________________________________
__________________________________
Please
print form, fill in the necessary information, make check payable
to Jane H. Connell and mail by April 14 to:
Jane H. Connell
P.O. Box 455
Ripley, TN 38063
Phone: 731.635.1951
e-mail: accentsgifts@bellsouth.net
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