The Kellermann Foundation

Safari Dinner Reservation Request



September 30, 2007
Mark your calendar!

 

 

 

 

 

 

 

 

 















 

 

 


Kellermann Foundation Appreciation Dinner
September 30, 2007
at
Miner's Foundry, Nevada City, CA


Reservation Form

Today's Date
Phone
Your E-mail
Mailing Address
City, State
Zip

Pay by Check

 

I will mail a check to:
  The Kellermann Foundation - 2006 Dinner
  P.O. Box 1901
  Penn Valley, CA  95946
Please charge my credit card
Credit Card Type
Card Number
Exp Date - MM/YY

 

Dinner Reservation Details & Cost

Number in your party
Special Seating Request?

Total Payment Due
Cost per person is $100

$

I won't be able to attend but
I would like to make a donation

$
Check or credit cards accepted.

 

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