| Please send me ____ tickets @ $20.00 each. |
| ____ I would like a scholarship ticket. |
| ____ I will contribute _____ for scholarships. |
| ____ I want to be a supporter of the program for $15.00 (includes your
name and quick quote in the program book. Quote:
|
| ____ I would like to be an Underwriter of event expenses @ $150 or
more. |
| |
| Name: ___________________________________________________ |
| Address: _________________________________________________ |
| ________________________________________________________ |
| City: ________________________ State: ______ Zip: _____________ |
| Phone: _________________________ Email: ____________________ |
| ____ I have enclosed a check/money order in the amount of ___________ |
| ____ Please use my Visa/Mastercard. Exp.date _________ |
| Account# _________________________________________________ |
| Signature _________________________________________________ |
| |
| Send form to: Thomas Merton Center
Attn: New Person Award
5125 Penn Avenue
Pittsburgh, PA 15224 |
| |
