OSU Alumni Club of Stark County

Tailgate Mixer with Dr. Gee

Monday, June 9, 2008

5:00 PM

Brookside Country Club

Name: ___________________________________________________________

Address: _________________________________________________________

________________________________________________________________

Phone:  ______________________ (Day) __________________ (Evening)

Email: ___________________________________________________________

Reservations:     _________ Members (@ $20) and _________ Non-Members (@$25)

Club Membership Dues:  _________ $20/Person   ________ $30/Couple (Checkmark your choice and also checkmark the names who are joining please)

(Membership includes you in our future mailings and helps cover the cost of those communications and our scholarship activities)

Optional Donation to our Scholarship Fund: $_______________

Total Enclosed: ______________

Additional Names on Reservation:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

Send your check payable to "The OSU Alumni Club of Stark County" to:

OSU Alumni Club of Stark County

c/o Buckeye Engineering Services

4916 Spruce Hill Dr NW, Suite 300

Canton, OH 44718