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	5 Hooper Lane Petitcodiac, NB Canada E4Z 0B4


	Phone:506-756-2110 Fax: 506-756-2094 E-mail: maritime motorsports@gmail.com www.maritimemotorsporthalloffame.com

MARITIME MOTORSPORTS HALL OF FAME INC.
5th ANNUAL FORMAL INDUCTION DINNER

CASINO NEW BRUNSWICK
21 Casino Dr., Moncton, NB, E1G 0R7

SATURDAY, NOVEMBER 6, 2010

Meet & Greet 5:00 P.M. - Dinner 6:00 P.M. - Induction follows

Contact Name____________________________________ Phone #_________________

Street __________________________________________________________________

City_____________________ Prov. ____________ Postal Code___________________

E-Mail Address ____________________________

Number of TICKETS _____________ @ $80.00 each = $_________

(Tables of 8)

Following is a list of attending guest:
(Please print, as this is how your nametags will read)

1.____________________________________ 5. ________________________________

2.____________________________________ 6. ________________________________

3.____________________________________ 7. ________________________________

4.____________________________________ 8. ________________________________

Number of persons attending Brunch at the Hall, Nov. 7 @ 11:00am____$10.00 each = ______

More order forms available upon request.

Must confirm your attendance by October 25^th.

PAYMENT: Cheque or Money Order payable to MARITIME MOTORSPORTS HALL OF FAME INC.

Enclosed is my cheque/money order in the amount of $____________

Please return order form and cheque/money order to:

Maritime Motorsports Hall Of Fame Inc.

5 Hooper Lane, Petitcodiac, NB, E4Z 0B4