Senator Byron Dorgan

LUNCHEON RESERVATION FORM

Please reserve _________ place(s) at the Wednesday 24 February luncheon at a charge of $55 per person for Aero Club members if paid in advance and $60 for non-members. All attendees will be charged $60 if paying at the door. No cancellations or refunds after Friday, 19 February 2010.

Enclosed is my check for $ __________________

Charge my VISA or MasterCard

Card# ____________________ Exp. Date ______________ 3 digit Sec Code__ __ __

Name _____________________ Telephone ______________

Guests _____________________, ____________________, _____________________, _____________________

Company Name _____________________________________