STAR AWARDS RESERVATION FORM

DEADLINE FOR RESERVATIONS MUST BE
POSTMARKED BY THURSDAY, MAY 24, 2007

PLEASE PRINT


NAME_____________________________________________________________

ADDRESS__________________________________________________________

CITY________________________________STATE_________ZIP____________

PHONE___________________E-MAIL ADDRESS___________________________


NUMBER OF TICKETS_____________AT $60 EACH

______WE WANT TO RESERVE A TABLE OF EIGHT AT A $30 SAVINGS ($450)

NAME OR ORGANIZATION FOR SIGN ON TABLE___________________________

PLEASE LIST ALL NAMES IN PARTY BESIDES YOURSELF:

1._______________________________________________________________
2._______________________________________________________________
3._______________________________________________________________
4._______________________________________________________________
5._______________________________________________________________
6._______________________________________________________________
7._______________________________________________________________

MY CHECK IS ENCLOSED FOR __________(Your cancelled check is your receipt)

_______ I WOULD ALSO LIKE TO MAKE A DONATION TO SPEAK FOR
HUMANE EDUACTION

SEND TO:   
SPEAK - Star Awards
5012 S. Washtenaw Ave.
Chicago, IL 60632

ALL NAMES WILL BE HELD AT THE DOOR.

FEEL FREE TO CONFIRM YOUR RESERVATION BY CONTACTING SPEAK AT
speakonline@comcast.net  OR  773.925.8227

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