Pre-Registration & Order Form

I will wish to register as a member. Adult only at $100.00 each…. $

I wish to purchase Adult Dinner Ticket at $50.00 each…. $

I wish to purchase Minor Dinner Ticket at $35.00 each…. $

I am unable to attend. Enclosed is a non-tax deductible donation for $

Total: $

Amount Enclosed: $

Note

Please mail all checks payable to ABONNEMA FOUNDATION, INC., P O Box 51082, Durham, North Carolina 27717 or Direct Deposit/Wire Transmit at Wells Fargo Bank, Account (ATN): 6808159179, Routing (RTN): 111900659

Please return this form with payment receipt not later than AUGUST 25, 2019

Return self-addressed and stamped envelope enclosed.

Check this Box For Public Acknowledgement.