Blue Hen Basketball Club
Trip Sign Up
Form 2009-2010
UD Women at Drexel, January 31, 2010 (12:00 Noon)
·
Number attending
@ $25* per person: _____
UD Men at Drexel, February 13, 2010 (12:00 Noon)
·
Number attending
@ $25* per person: _____
*$35 for non members
Amount Enclosed: _____
NAME (s):
ADDRESS:
CITY:
STATE: ZIP CODE:
PHONE NUMBERS:
HOME:
WORK:
CELL:
E-MAIL ADDRESS:
Please send check payable
to Blue Hen Basketball Club to P.O.Box 9803 Newark, DE 19714-4903
If you have any questions,
please contact Dick Schwer