PPMT Print Competition

POTLUCKSIGNUP•••••••••••••••••••••••••••••••
Summer Picnic • Tues. June 13, 2017

First Name:

Phone:

Last Name:

Email:

Address Line 1:

City:

Address Line 2:

State:

Zip:

Please RSVP and Complete By: June 5, 2017

Will you be able to attend the event?

Number attending

PPMT 2017 Summer Picnic Potluck Signup

Please indicate whether you will contribute money toward the purchase of the meat. You may submit payment throught this secure form by entering your credit card information.

~Or~

if you wish to bring something, please choose at least one dish AND a miscellaneous item. Please check your selections below the payment form.

I WILL CONTRIBUTE TOWARD THE COST OF MEAT

I WILL CONTRIBUTE TOWARD THE COST OF MEAT (Recommended $5 per person)$10.00

Quantity
Item subtotal:

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

I WILL BRING SOMETHING YUMMY TO SHARE

I WILL ALSO BRING A MISCELLANEOUS ITEM