To pay by credit card include the following information:
MASTERCARD_________ VISA________
Number: _________-___________-___________-___________ Expiration: ___________
Name on card: ________________________ Signature: __________________________
Please reserve the following:
Dinner Tickets @ $60.00 each Number of tickets _____ Amount __________
Tables for ten @ $500 Number of tables _____ Amount __________
Total ___________
| Dinner Selection | Number |
| Boneless Breast of Capon | ________ |
| Roast Prime Rib of Beef | ________ |
| Stuffed Sole Florentine | ________ |
Kindly R.S.V.P. by Nov. 3th, 2000
Please send your check and Order Form to JCAA
Awards Dinner, 1201 Route 37 East, Suite 9, Toms River, NJ 08753
OR Fax your order form with a credit card number to 732-506-6975