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Print out this form and send with check to address below....

Laughlin Reservation Form

February 24 February 28, 2019

Cost - $ 80.00 per person, $85.00 per person after Jan 1, 2019


Name: __________________________________________________

Year Graduated From NE: __________

Spouse or Guest Name: ________________________________

If Spouse or Guest Graduated From NE... Year Graduated: __________

Address: ________________________________________________

City: _______________________________

State: ________________

Zip: __________________

Phone: ______________________

Email Address: ___________________________________________


Indicate Interest: # ____ Jet Boat to Havasu (optional)

  (We will contact you with cost of jet boat event)

Amount Enclosed: $__________________


Mail Checks Payable To: "Carol Lee Piraro"

Send This Form And Check To:

Deena Gibson
9036 W. Port Royale Lane
Peoria, AZ  85381
(314-739-9980) If you need to call.