Rajah Mounted Patrol Western/Ladies Night Reservation Form

 Rajah Mounted Patrol's 
Annual Western & Ladies Night
Saturday, May 22, 2004
Rajah Shrine Complex & Pavilion
Name:__________________________________

Street:__________________________________

City:____________________________________

Unit/Club:________________________________

 Lady:_____________________

Phone:____________________

State: _______ZIP:__________

Temple: ___________________

Enclosed is my check in the amount of __________ for $15/person
made payable to "Rajah Mounted Patrol".  

Send Check and Completed Reservation Info to:
Ray Haslam
P.O. Box 574
Leesport, PA  19533

If you need more information, Call Ray Haslam, Jr. at 610-926-9583
 

Deadline for reservations is Saturday, May 14, 2004

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