Jane Austen Society of North America
  North Texas Region
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JASNA-NTX  
December Birthday Luncheon
Saturday, December 16th, 2017
Mail-In Registration Form

Name:  _________________________________________________________________
 
E-Mail Address:  _______________________________________________________
 
Phone #:  _______________________________________________________________
 
 
Early Registration:
JASNA Member/Guest @ $40        __________    
                                                                                 
   
# of Guests @ $40/each                 __________     (please list all guest names below)

                                                                                    
Donation                                            __________         
 

Total amount due                           $__________
 
 
Checks may be payable to JASNA-NTX and mailed with this form to:

Vicki Ford
1720 Woodhill Lane
Bedford, TX  76021
 
 Please list guest names below:

 _______________________________________________________________
 
 _______________________________________________________________
 
 _______________________________________________________________
 
 _______________________________________________________________
 
 
See you there!