ent000987-005

?ç?ç RESERVATION - CONTRIBUTION FORM : table(s) Kindly reserve for the "Men of the Year" Dinner seats honoring ^>&it and ^>9tit ^acAa,%ae& I enclose my check in the amount of $ * for the following reservations* No. of Seats (a $75.00 per person (Tables seat 10 or more) NAME (please print) ADDRESS TELEPHONE Q Although I cannot attend the dinner, I am happy to enclose my contribution of $ * *Please make your tax-deductible check payable to "March of Dimes" and mail to Earl Wilson, Penthouse, 29 West 56th Street, New York, N. Y. 10019. (CO 5-7460) If you have not yet completed your guest list, please detach form below and return to us when your guest list is completed. (host) GUEST LIST NAME OF GUESTS ADDRESSES 1. 2. 3. 4. 5. 6. 7. 8. 9. 10 -Please make your tax-deductible check payable to "March of Dimes" and mail to Earl Wilson, Penthouse, 29 West 56th Street, New York, N. Y. 10019. (CO 5-7460) 0123