UW-La Crosse
Alumni Reunion Weekend
Oct. 19-21, 2012
Registration Form
EVENTS
Friday, Oct. 19
Motorized campus tour
3 p.m. (Limited to first 20 registrants)
Old fashioned Wisconsin Fish Fry
5 p.m. (includes tax & gratuity)
Alumni dessert social & sing-a-long
7 p.m.
Theatre production, “Mirror of the
Invisible world”
7:30 p.m.
Saturday, Oct. 20
Beta Sigma Chi breakfast
8:30 a.m.
Walking campus tour
10 a.m.
Football game vs. UW-Stout
1 p.m.
50th Reunion Celebration Dinner
5:30 p.m.
Theatre production, “Mirror of the
Invisible world”
7:30 p.m.
Class Scholarship gift
Alumni Association
annual membership dues
# ATTENDING
COST PER PERSON
TOTAL
No charge
n/c
$15
$
No charge
n/c
$10
$10
$
No charge
n/c
$10
$
$20
$
$10
Designate class $
year _______
$35
$
$
TOTAL
$
-COMPLETE AND RETURN BY OCTOBER 1, 2012- More information on reverse side -
(PLEASE PRINT)
Full name ___________________________________Maiden_________________
Address ______________________________________Grad year_____________
City ____________________________ State: ___________ Zip: ______________
Phone ________________ E-mail _______________________________________
Your preferred name on name tag______________________________________
Guest/spouse name on name tag_______________________________________
If guest/spouse is an alum, please note grad year _________________________
Special dietary/physical needs_________________________________________
Method of payment (circle one):
VISA
MC
AMEX
CHECK (enclosed)
For credit card payment, cardholder’s name:______________________________
Card number: _______________________________________________________
Exp. Date: _____________________ Security code (3 digits on back) _________
Registration deadline – Oct. 1, 2012
Return all registration materials to:
UW-L Alumni Association l Cleary Alumni & Friends Center
615 East Ave. N. l La Crosse, WI 54601
Toll free (877) 895-2586 l Local (608) 785-8489 l Fax: (608) 785-6868
alumni@uwlax.edu l www.uwlalumni.org