John Carroll High School�Annual 300 Club Dinner, Dance, and Auction�

Friday, February 5, 2010, 6:00 pm�

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Address: ___________________________________�

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Phone:_____________________________________�

Email:______________________________________�[ ] I / We will be attending [ ] I / We will not be attending�

Number attending __________�

Payment information:�

[ ] I would like__________ tickets for a total of $__________�

[ ] I wish to charge the above selection for a total $________�(MC, Visa, AMEX)�

Number:_____________________ Exp. Date:___________�I / we would like to be seated with the following people (8 people per table):�

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Please return form with payment before January 22, 2010�