Ben DeLa Vega's
27th Annual Black and White Ball
Friday, October 18th, 2019
7:00 p.m - 11:45 p.m.
Reservation Form
| Name: __________________________________________ |
| Address: _________________________________________ |
| City: ___________________ State: ____ Zip Code: ________ |
| Daytime Phone: ____________________ |
| Evening Phone: ____________________ |
| E-Mail: ______________________________________ |
|
Event fee $140/person x Number attending ______ Total Remittance = $__________ * Special Event Tickets are non-refundable. All sales are final * |
Please R.S.V.P. your attendance by October 10th, 2019
Please make checks or money order payable to: Ben De La Vega
Address: 940 East Beltline Road, Suite 132, Richardson, Texas 75081
For further info: Call Ben at 972.231.7433 or PJ at 972.693.7651
or Email: pj.dancetique@sbcglobal.net / Website: www.pjsdancetique.net
*We appreciate your support*