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Physician Assistant
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Second annual pA friends & alumni celebration RSVP
Header 1
The University of Findlay Second Annual PA Friends & Alumni Celebration
Saturday, March 23, 2013
Are you able to join us?
*
Are you able to join us?
Can't wait!
Can't come, but I would like to donate!
First Name
*
Last Name
*
Email
*
Meal Choice
*
Please Select ...
NY Strip
Chicken
Vegetarian
Guest First Name
Guest Last Name
Guest Meal Choice
Please Select ...
NY Strip
Chicken
Vegetarian
Total number of dinner tickets needed
*
What is your affiliation to the PA program
*
Please Select ...
Preceptor
Area Physician
Area Physician Assistant
Student of 2014
Student of 2013
Alumni Class of 2012
Alumni Class of 2010
Alumni Class of 2009
Alumni Class of 2008
Alumni Class of 2007
Alumni Class of 2006
Alumni Class of 2005
Alumni Class of 2004
Alumni Class of 2003
Alumni Class of 2002
Alumni Class of 2001
Alumni Class of 2000
Payment
Dinner tickets are $75 for individual purchase
*Meals will not be available for purchase the day of the event.*
Please consider making a donation to the Dr. Richard E. and Jean K. Davis Scholarship Endowment Fund. Donations will be accepted the night of the event or can be made with this RSVP - just add your donation amount below.
Donation amount (optional)
Total amount to be charged to your card
$
Cardholders Name
*
Card Type
*
Please Select ...
Visa
Mastercard
Discover
American Express
Credit Card Number
*
Expiration Date
*
3 or 4 Digit Code (CVC/CV2/CID2)
*
Comments
We're Sorry You're Unable to Attend
We want to stay in touch with you!
First Name
*
Last Name
*
Address
*
City
*
State
*
ZIP
*
Phone/Cell
Email
*
What is your affiliation to the PA program
*
Please Select ...
Preceptor
Area Physician
Area Physician Assistant
Alumni Class of 2014
Alumni Class of 2013
Alumni Class of 2012
Alumni Class of 2010
Alumni Class of 2009
Alumni Class of 2008
Alumni Class of 2007
Alumni Class of 2006
Alumni Class of 2005
Alumni Class of 2004
Alumni Class of 2003
Alumni Class of 2002
Alumni Class of 2001
Alumni Class of 2000
Donation
Please consider making a donation to the Dr. Richard E. and Jean K. Davis Scholarship Endowment Fund.
Donation amount (optional)
Total amount to be charged to your card
$
Cardholders Name
Card Type
Please Select ...
VISA
Mastercard
Discover
American Express
Credit Card Number
Expiration Date
3 or 4 Digit Code (CVC/CV2/CID2)
Comments
Mail Your Payment
Make your check payable to:
The University of Findlay
Please mail or drop off your payment to:
The University of Findlay
PA Office
ATTN: Peggy McBride
1000 N. Main St.
Findlay, OH 45840
Any questions, please contact:
Peggy McBride
419-434-4529
mcbride@findlay.edu
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