Great Rosarians of the World East Coast Registration Form for Art Exhibit & The 3rd Manhattan Rose Council Dinner

Fill out this form, print it, and then Mail it to: Pat Shanley, PO Box 442, Locust Valley, NY 11560

Or Email the information below to: east@greatrosarians.com

Please Make Checks Payable To: Manhattan Rose Society

First Name:
Last Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
Number of Tickets for Art Exhibit Requested (no charge):

Number of Tickets for Dinner @ $100.00 each*

*By March 1, 2008

Number of Tickets for Dinner @ $125.00*

*After March 1
Total: