PAGE THREE
 Activity Sign Up Sheet

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Print and use this sheet for any of the following events.
Name     _____________________________________
Address   ____________________________________
City and Zip    ________________________________
Home Phone _____________________________________
Work Phone ____________________________________
E-mail _________________________________________
Event 1 _________________________________________
Event 2 _________________________________________
Event 3 _________________________________________
Event 4 _________________________________________
Deposit Amount Event 1___________________________
Deposit Amount Event 2___________________________
Deposit Amount Event 3___________________________
Deposit Amount Event 4___________________________
Total Deposit Amount ____________________________
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Send this form and checks payable to "ASGA, Detroit Chapter" to:

Eileen Ames

14951 Robinwood
Plymouth, MI 48170

eames@comcast.net
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