ALS Extravaganza Guest List Form

Name:
Address:
Phone:
Tickets Required: at $100 each

Invitations will be mailed by October 1, 2003.  Payment is expected at that time.

Thank you for making a difference

ALS of Utica
c/o Advanced Tool
9169 State Route 49
Marcy, NY 13403
Phone:  315-768-8502
Fax: 315-768-4807

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