REQUEST FOR ADDITIONAL DINNER TICKETS

Dinner is Free for the Student Nominee and ONE Guest
Additional Guest Tickets are available for $30.00 each

Request for Tickets Must Be Recieved by May 16, 2008

Checks should be made payable to LI-ACS HS Awards and sent to:
Dr. Ralph Stephani
St. John's University
8000 Utopia Parkway
Jamaica, NY 11439

High School Name
Nominator Name
Nominator E-mail address
Student Name
Number of Additional Tickets including Nominee and Guest  

PLEASE... Review the above data for accuracy before submitting.