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.
MURA printable registration form
Attendee Information (Please print):
| Person #1 – First and Last Name* | Person #2 – First and Last Name* |
| Email: | Email: |
| 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.