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" RESERVATION FORM

Please complete this form fully. Print & mail the form with your payment to:
Kim Tahey, 104 Montrose, Williamsburg, VA 23188

EVENT No. of Attendees Price Total

1. Elegant Dinner & Jolly Coachmen _______ $110/per person ______
Dinner Choice. # of: Chicken ______
Salmon ______
Vegetarian ______
2. Virginia Fine Arts Museum Trip _______ $75/per person ________
(opt.) Hopper Exhibit _______ $16/per person ________

3. Grand Prix Racing & Ships Party _______ $65/per person ________
4. Chef’s Kitchen (circle) #I or #II _______ $140/per person ________
5. Pulk Party ?? _______ $/person ________
6. Private Dinner at the Trellis _______ $125/per person ________
7. La Yaca Luncheon _______ $60/per person ________

8. Summer Brunch with Mystery Chef _______ $100/per person ________

TOTAL RESERVATION BALANCE ENCLOSED $ __________

Optional deductible tax donation included — it always helps! $ __________

Please print carefully.
Name _______________________________________________________________

Address ______________________________________________________________
___________________________________________________

Phone ______________________________________________________________
Email Address REQUIRED (Please print clearly.)
_____________________________________________________________________
Confirmation will be sent by email.

Please provide names and phone numbers of all guests attending on the following separate page.

Enclosed is my check, payable to the Williamsburg Symphony Orchestra League,
in the amount of $ __________________

- Or -
Charge my credit card (circle one) MasterCard VISA American Express
Print name as it appears on credit card: (3% processing fee charged)

Name ______________________________________________________________

Signature ____________________________________________________________

Acct. No. ____________________________________________________________

Exp. Date ___________________ Security Code _________________