MURA Breakfast Pre-registration Mail-in Form
February – June 2018
- You may use this form to pre-register for a single breakfast or for multiple breakfasts. The cost is $13 per person per breakfast.
- Payment is required with all pre-registrations.
- NO REFUNDS WILL BE MADE, but you may give or assign your pre-paid reservation to another individual.
- Pre-registrations must be received no later than five days prior to the event. See the chart below for due dates.
Attendee Information (Please print):
|Person #1 – First and Last Name*||Person #2 – First and Last Name*|
|Phone: ( )||Phone: ( )|
* Please provide any updates or changes for mailing addresses:
Registration Choices, Payment and Due Dates:
Breakfast Event Date (2018)
|Person #1 will attend: (Yes or No)||Person #2 will attend: (Yes or No)||Amount (# persons x $13.00 per event per date)||
Paid pre-registration due by:
|February 6||$||February 1|
|March 6||$||March 1|
|April 3||$||March 29|
|May 1||$||April 26|
|June 5||$||May 31|
|Total Amount Submitted:||$|
Make checks payable to: MURA (MU Retirees Association)
Mail pre-registration form and payment by check to: Jack Miles, 4001 Bent Oak Dr., Columbia, MO, 65203.