"Mary Hoyer - A 100 Year Celebration"
Reservation Form

Please print and mail this form to:

Historical Society of Berks County
940 Centre Avenue
Reading, PA 19601

Any questions?
Call: Tadd K. Casner

610-236-0488


Name: __________________________________________

Address: ________________________________________

City: ______________________State: _____ Zip: ________

Phone: __________________________________________

I wish to make _____ reservations at $350 each................................................................................ $________
   

Luncheon reservation requires Historical Society membership;
                                                                                   please add $25 if not a current member............

 $________
   
                                                                                                                                                    Total.......... $________
   
I am unable to attend the Gala Luncheon, but would like to order the Commemorative Doll.... $      250.00
                                                                                                                  PA residents add 6% tax......... $        15.00
                                                                                                                  Shipping & Handling................ $ __  16.00
   
                                                                                                                                                    Total.......... $________
___ I will pick up at the Historical Society to save Shipping & Handling.  

Please make check payable to:  "Historical Society of Berks County"

Please charge my:        ___ VISA                     ___ Mastercard

Name on card: _______________________________
Card #: _______________________________
Exp. Date: _______________________________
Signature: _______________________________

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