| Member* | $85.00 x _____ = |
$ ________ |
| Non-members | $95.00 x _____ = |
$ ________ |
| Tables of 10 | $950.00 x _____ = |
$ ________ |
| Additional Gift | $ ________ | |
Total Enclosed: |
$ ________ |
*The Member price is available to Members only. Non-member guests of members pay the Non-member price.
PLEASE MAKE YOUR CHECK PAYABLE TO:
BROADCAST PIONEERS OF PHILADELPHIA