Historical Society Dinner Reservations
Name *
Billing Address *
City *
State *
Zip Code *
No. Tickets @ $18 ea. for members. *
No. Tickets @ $22 ea. for non-members. *
Check box to request a vegetarian dinner.
If you would like to charge this dinner to your credit card, please fill out the info below:
Mastercard/Visa Credit Card Number
Exp. Date
E-Mail Address *
Would you like to receive information
on future events by E-mail.
Yes
No
* = Input is required