German American Day - Connecticut

Reservation Form

Please print the form below, complete it and send it with your check to:
Karl Schidat
343 Niblick Lane
Oxford , CT 06478
kschidat@hotmail.com

Name:______________________________________________________

Address:____________________________________________________

___________________________________________________________

Phone:______________________________________________________

_____Prime Rib (state rare, medium or well)	_____Nantucket Scallop Casserole
_____Baked Stuffed Shrimp	_____Chicken Florentine

Total Reservations:_______ @ $65 each	Check Enclosed $________