Clergy-Musician Dinner
On-line Reservation Form

Friday, January 24, 2003 - 6:00 p.m.
Our Savior's Lutheran Church - Sun Prairie

Cost is $20 for one ACM member and one clergy guest or
$10 for an ACM member alone, or for each additional guest, and
$15 for non-ACM members.

Your reservation will be completed when a check is sent by mail to:

ACM Clergy-Musician Dinner
PO Box 5321
Madison, WI 53705

Name of Church:
City/State:
Contact Phone:
Contact E-Mail:
This is an ACM member church.
This is not an ACM member church.

In the following space, please list the names of all ACM members, clergy or guests who will be attending the Clergy-Musician Dinner from your church.

Number of Chicken Stir-Fry Meals:
Number of Vegetable Stir-Fry Meals:
Total Amount of Payment to be mailed to ACM: