PHARA

ANNUAL

HOTDOG SOCIAL & CRAWFISH BOIL

APRIL 30, 2011

Reservation Form for Crawfish boil

(before April 25, 2011)

Name ________________________ Call ____________________

Address _______________________ Phone (____)_______________

City _________________________ e-mail __________________________

State/Zip ______________________

Crawfish boil _______ @ $15.00 per person = $_____._______

Mail completed form with payment to: PHARA

(Before April 24, 2010) 555 Pisgah Church Rd.

Bernice, La. 71222

Make checks payable to PHARA

Tickets will be sent back to you to use for conformation of purchase.