form

Please use 'Print page' link at the bottom of the page, print, complete and mail with your check as directed below.

Reservation Request

Lecture & Reception at the Broad Institute
Wednesday September 14, 2011 at 6 pm

Reservation Deadline: Friday, September 9th, 2011

Alumni of Oxford and Cambridge interested in joining the Society, as well as existing members of the Society, and their guests, are all welcome to this event.

Please note: Light refreshments and soft drinks at the reception are included in the price. For alumni new to the Society, 2011-12 membership is also included.

 Please reserve _______ place(s) for me @ $20 each                        

 Total amount enclosed $ _______

  

            Name: __________________________________    College: __________________________

            Street Address: ___________________________   Daytime Phone: ___________________

            City/State/Zip: ____________________________  Evening Phone: ___________________

Guests and Colleges, if applicable_______________________________________________

Please complete and return this entire page together with a check for the total amount payable to Oxford and Cambridge Society of New England, Inc. and mail to:-         

Dr. Richard J.W. Mansfield, Reservations
225 Walden Street, Apt. 2-s
Cambridge MA  02140

E-mail: rjwmansfield@post.harvard.edu