Please print this page; return this form with your contribution! Thank you!

Please reserve ______seat(s) at $25 per person, or_______table(s) at $200 (8 persons)

Make checks payable to:
The Home Place
P.O.Box 1476
Hixson TN 37343-5476

_____ I am unable to attend the benefit but have enclosed my donation to support the efforts of The Home Place. Name:__________________________________________________Phone______________________

Address:______________________________City___________________________Zip____________

Email______________________________________________________________________________

Please respond by April 9th to be assured a reservation! All proceeds from this benefit go to The Home Place
Call: 423-870-6282 if you need more information.  Questions? Send E-mail to Sister Adamarie

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