Ladies Appreciation Night
Reservation Form


Saturday, February 16th
6:30pm

Reservations Required - No ticket sales at the door

Please fill in the blanks, using your tab key to move between fields.
Type first and last name(s) of each person you are making a reservation for.

 

Name
Address
Address
CityState ..Zip -
Phone( ) .Email

Use box for additional reservations or to
Send a comment to
1st Chieftain Ian Purvis


Entree Selection

Indicate the number of each entree: Beef . Chicken Vegetarian



Price

Indicate Number of Reservations Men...............................$45.00
Ladies...........................No Charge




To process your reservation press Submit