MURA Breakfast Pre-registration Mail-in Form

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.

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