RAMBLING GEMS January 25, 2020

RED HAT LUAU RESERVATION FORM

ONE CHECK PLEASE

Chapter Name______________________________________

Location_____________________ Chapter ID #____________

QM's Name________________________________

QM's Phone ________________ RHS Member #___________

Email__________________________________

Be prepared to show your RHS member card if requested.

1. Attendees Name: ______________________ RHS Member #___________

2. Attendees Name: ______________________ RHS Member #___________

3. Attendees Name: ______________________ RHS Member #___________

4. Attendees Name: ______________________ RHS Member #___________

5. Attendees Name: ______________________ RHS Member #___________

6. Attendees Name: ______________________ RHS Member #___________

7. Attendees Name: ______________________ RHS Member #___________

8. Attendees Name: ______________________ RHS Member #___________

9. Attendees Name: ______________________ RHS Member #___________

10. Attendees Name: _____________________ RHS Member #___________

Payable to: QM Joanne LeBoutillier and mailed to

421 Maple Tree Dr. #310, ALTOONA, FL 32702