REGISTRATION FORM

2003 “HALL OF FAME DAY” CELEBRATION

Location

Genetti Lodge

Route 309 North

Hazleton, PA

Banquet Registration

Please make check ($35.00  per person) payable to “Wrestling Hall of  Fame, Pa. Chapter” and return                                          

by April 15^th.

NAME______________________________NUMBER ATTENDING____

NAME(S) OF

GUESTS:_____________________________________________________

AMOUNT ENCLOSED:________________________________________

SPECIAL SEATING

REQUEST:___________________________________________________

        _____________________________________________________________

      I (WE) ARE ATTENDING IN HONOR OF (RECIPIENT’S NAME):

        ____________________________________________________________

HONOREES’ SPECIAL CONTRIBUTION

Yes, I (We) want to honor (Honorees” Name(s) _____________________

and support the National Wrestling Hall Of Fame by sending a special

contribution of:

            ____$25.00    ____$50.00    ____$75.00        _____Other

This contribution is tax deductible.  Your name will be included on the

banquet program listed by each honoree.   Please write below how you wish    

to have your name listed.

____________________________________________________________

RETURN COMPLETED FORM TO:   National Wrestling Hall of Fame

                                                                          State Chapter of Pennsylvania

                                                                    40 North Clay St.

                                                                          Manheim, Pa. 17545 

Your tickets will be at the registration table day of banquet