Registration Form for the O’Connell Family Fundraiser
This part of the registration form to be printed and mailed to
Shannon Seneczko
23504 West William Court
Plainfield, IL 60544
Thank you for your support
Number of Lady Registrations Being Purchased _____
Number of Gentlemen Registrations Being Purchased _____
Number of Unable to Attend Registrations Being Purchased (I won’t be there, but want to donate a registration fee and receive a ticket in the 50/50 Raffle) _____
Names and Phone Numbers of Attendees/Donators: