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Please print the form below, complete it and send it with your check to:
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Name:______________________________________________________ |
| Address:____________________________________________________ |
| ___________________________________________________________ |
| ___________________________________________________________ |
| Phone:______________________________________________________ |
| _____Prime Rib (state rare, medium or well) |
_____Chicken a la Kathryn |
| _____Baked Stuffed Shrimp | _____Scrod Mediterranean |
| Total Reservations:_______ @ $60 each | Check Enclosed $________ |
For Ticket Information Call: Karl Schidat at 203-888-5976