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Miami
Killian Class of 1970 Registration Form
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Killian
30 Year
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Miami Killian Class of 1970 --
Reunion Cruise Name(s) and Cabin Needs 1:______________________________________________________ 2:______________________________________________________ 3:______________________________________________________ 4:______________________________________________________ Type of Cabin Requested ______________single/double/triple/quad Total Cabin Cost: _____________________________
Your Contact Information ________________________________________ ________________________________________ Phone Number ______________________________ FAX Number _______________________________ Email Address ______________________________
Special Needs and
Payment Information Air Transportation Needed to Miami ________________________ Need a Room Mate? ___________________________________
Form of Payment Credit Card (type, number and exp. date) ______________________ Amount Paid Now _______________________________
Mail this form
to: Or you can FAX it if paying by credit card: 1-704-587-9331 |