AMHS Alumni Association

Monday, October 30, 2017
6:00pm - 9:00pm
$45 per person
The PLACE (formerly The Clubhouse)
191 South Main Street, New City, NY 10956

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Contact Information * required information

Title:     First Name:*     Last Name:*     Maiden Name:

Street Address:*     City:*     State:*     Zip:*

Phone:* ( ) -     Email:*

Select all that apply:  Past Parent     Current Parent     Faculty     Former Faculty     Friend     Alum     Class Of:


Attendees

$45 per person    

      


Payment

Total Amount to be Paid by Credit Card: $

Card Type:*     Card Number:*     Security Code:*     Exp Date:*

First Name:*     Last Name:*

Address:*     City:*     State:*     Zip:*    

Country:*


Questions?

Please call the Albertus Development Office at (845) 623-8842, ext. 229


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