Please Print Name Exactly As You Wish For It To Appear In Printed Materials.
Name of Individual or Firm
Contact Person
Daytime Phone
Title
Fax
E-mail
Address
City
State
Zip
Reservation Information
o Enclosed is a check for $
Made payable to University Of Houston.
o I am/we are unable to attend. Enclosed Is my/our check in the amount of $
o Please charge my/our o Amex o Visa o MasterCard o Discover
Card Number
Billing Address
3-digit CVV
Name On Card
Exp. Date
Guest List (Lines For Each Name)
1.
2.
3.
4
5.
6.
7.
8.
9.
10.
Please return form by mail, e-mail, or fax to:
Vernon E. King
Director of Advancement
University of Houston, College of Technology
4730 Calhoun Rd – Room 300
Houston TX 77204
Office 713-743-4886 | Fax 713-743-5699
Email: veking@central.uh.edu
HE37851RN | AICHC
Proceeds from this event will benefit student
scholarships and the Star Endowment for
Retailing and Consumer Science and Global
Retailing at the University of Houston.
All gifts to the University of Houston are tax
deductible to the extent allowed by law. In
compliance with IRS tax reporting laws, the
amount of your charitable contribution is
limited to the excess of your payment over
the value of goods or services.
.