* Required

First Namerequired

Last Namerequired

Emailrequired

Phonerequired

How many, including yourself, will be attending?*

$50 per person

0 1 2 3 4 5 6

Please include all registrants information, including yourself as the first guest.

Your First Namerequired

Your Last Namerequired

Is this guest an alum?*

Yes No

Maiden Name

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

First Name of 2nd Attendeerequired

Last Name of 2nd Attendeerequired

Is this guest an alum?*

Yes No

Maiden Name of 2nd Attendee

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

First Name of 3rd Attendeerequired

Last Name of 3rd Attendeerequired

Is this guest an alum?*

Yes No

Maiden Name of 3rd Attendee

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

First Name of 4th Attendeerequired

Last Name of 4th Attendeerequired

Is this guest an alum?*

Yes No

Maiden Name of 4th Attendee

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

First Name of 5th Attendeerequired

Last Name of 5th Attendeerequired

Is this guest an alum?*

Yes No

Maiden Name of 5th Attendee

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

First Name of 6th Attendeerequired

Last Name of 6th Attendeerequired

Is this guest an alum?*

Yes No

Maiden Name of 6th Attendee

I graduated from:*

Barat Hall City House Oak Hill Villa Duchesne

Graduation Yearrequired

If you are unable to attend, would you like to make a donation to the VDCHAA as a sponsor of An Evening of Cocktails & Comedy?

Yes No

Donation Amount

Additional drink tickets, gift basket raffle tickets, and 50/50 raffle tickets will be sold the night of the event. You can purchase those with cash or credit card.

Total Amount to be Charged:

Please send a confirmation email to the address below*:

Please provide an email address where we can send a link to your current form.

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