ANTELOPE CENTENNIAL
July 3, 2010

Registration Form

Please complete and return this form to Mary Ellen Holt, 613 Sunnyside Ave.,
Plentywood, MT  59254 by April 30, 2010.  

Name:______________________________________________

Maiden Name:__________________________Class Year_____

Spouse:_____________________________________________

Address:_____________________________________________

E-mail:______________________________________________

Telephone:___________________________________________

# Attending:__________________________________________

Registration July 2, 2010 from 4:00-7:00 pm at Sons of Norway Hall
and on July 3, 2010 starting at 8:00 a.m.
Website:  www.antelopemt.com
E-mail:  antelopecentennial@yahoo.com