SHOWCASE 2016 SIGN UP FORM

SHOWCASE 2016:
October 18, 2016
THE VUE
44-500 Indian Wells Lane
Indian Wells

SHOWCASE MENU ($48 per person $10 tax deductible) All net proceeds will benefit the Brandeis Scholarship Fund
Monies must be received by October 11, 2016

Main Course (Choose one):
(A) Cobb Salad
(B) Modified Cobb Salad (minus bacon)
(C) Vegetarian Option (if desired) is Pasta Primavera
Dessert: Key Lime Pie

Please print out this form, complete and attach your payment.
Make your check payable to: BRANDEIS NATIONAL COMMITTEE
Mail to: Rose Levy, 78075 Banyon Grove Court, Palm Desert, CA 92211

Name(s):_______________________________________________________

Meal Choice(s):_________________________________________________

Phone:_________________ E-mail:____________________________________________

Address:__________________________________________________________________

City, State & Zip:___________________________________________________________

Please reserve ________ seats @ $48.00 per person Enclosed is my check in the amount of $____________________

Please seat me with:____________________________________________________

Make your check payable to: BRANDEIS NATIONAL COMMITTEE Mail to: Rose Levy, 78075 Banyon Grove Court, Palm Desert, CA 92211 jsk 9/7/16