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	Reservation Form

	Please print and fill out this form and return it with your payment of $100 per person to:
		Class of 58 Reunion c/o Pat Taylor 8 King Road Middletown, RI 02842
	Your check should be made payable to: Class of 58 Reunion and should be mailed by June 15, 2018

	Your Name ____________________________________________________________________
	Spouse/Guest Name _____________________________________________________________
	Street ________________________________________________________________________
	City, State, Zip _________________________________________________________________
	Home Phone _____________________________
	Cell Phone _______________________________
	Email Address _________________________________________________________________
	School Attended ________________________________________________________________
	Number of Persons Attending ________
	Enclosed is a check for ______ Person/s in the amount of $___________.
	If you have any questions, please feel free to contact Pat O'Connell Taylor.