CSDB'S 135TH ANNIVERSARY

Reunion Combo Registration Form - June 26-27, 2009 -

One Form per person - Please Type or Print -
Please return this form after filing all information needed to complete your record. Thank you for your time and attention in responding to this form.

Name: _
Badge Information First ( print your name above as you wish shown on badge) First, Initial, Last Name

Maiden Name, If married: _

Mailing Address: _

City/State/Zip: _

Daytime Phone: ( ) _ Evening Phone: ( ) _

Videophone TTY Both _ Videopbone TTY Both _

Email Address: _

Year of Graduation: _ Year Left CSDB _

~ Circle the Price for YOU!- Register Early and Save! -

Combo Registration Includes: Basic Registration Fee * Social with Buffet * CSDB Campus Picnic * Dinner at Flying W Ranch.
- No Children will not be allow on Friday Night and Saturday Night-

Early Bird Combo Special Combo Late Special Combo

Ticket Deadline Ticket Deadline Ticket Deadline
March 1,2009 April 1,2009 June 1,2009
"'(per Person)"
CSDBAA Member, Regular $40.00 $45.00 $55.00
CSDBAA Member, Senior (55+) $35.00 $40.00 $50.00

Non-Member, Regular $55.00 $65.00 $75.00

Non-Member, Senior (55+) $50.00 $55.00 $85.00

For Reunion Dinner, Please circle what you would like to have: Chicken Beef Vegetarian
- Flying W Ranch Chuckwagon Suppers-

- CSDB Campus Picnic - Family Picnic All Day - June 27, 2009-
- Saturday only -11:00 a.m. - 2:00 p.m. -
CSDBAA Member $10.00 Non-Member $12.00 SENIOR CITIZEN (55+) $5.00
ClllLDREN/STUDENT (7+) $10.00 ClllLDREN UNDER 6 FREE

Payment Method
Total Payment: $ _
__ Personal Check (payable to CSDB Alumni Association) __ . Cashier's Check or Money Order Acceptable
Note: No Personal checks wiu be accepted after June 1, 2009

Mail this entire form with your check or money order to:
CAROLYN (LYNN) WILKINSON, CSDBAA Treasurer,
3445 BUNTERWOOD DRIVE, COLORADO SPRINGS, COLORADO 8091'