Reserved seating. As payment comes in your seat will be assigned.
Tickets
sold only through the Foundation of Mon General
Tickets must be purchased in advance
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Saturday, November 15, 2008
Number of Tickets ______ @ $22 each Total $________
o Check Enclosed o Charge to my o Visa o MasterCard o Discover
Name & Address: __________________________________________________________________
__________________________________________________________________________________
Expiration Date _________ Signature_______________________________________________
Telephone Number Day (_____) ____________________ Night (_____) __________________
Please make checks payable & mail this form to:
THE FOUNDATION OF MON GENERAL HOSPITAL
1200 J. D. ANDERSON DRIVE
MORGANTOWN, WV 26505
QUESTIONS: Please call Debbie Harn at (304) 598-1337
The Foundation is a non-profit organization. West Virginia residents may obtain a summary of the registration and financial documents from the Secretary of State, State Capitol, Charleston, WV 25305.
Registration does not imply endorsement.
WE THANK YOU FOR YOUR SUPPORT
Call Lakeview Reservations at 304-594-1111 or 1-800-624-8300