W I L L R O G E R S M E D A L L I O N A W A R D
®
2025 Will Rogers Medallion Award Banquet Ticket Order Form
November 1st, 2025 at the Hard Rock Hotel, Tulsa
Name: ________________________________________________________
Email: _________________________________________________________
I would like to order _______ Award Show Banquet tickets at $70 each
________ x $ = ________ Total
I would like to pay by:
Check (enclosed)______
Money Order (enclosed)______
My name tag(s) should read: __________________________________________, ______________________________ _____________________________, _____________________________________
Mail To: Laurie Cockerell
5313 Santa Marie Ave.
Fort Worth, Texas 76114
*Make checks out to Will Rogers Medallion Award, please
Due Date & Refund Policy:
Reservations due by October 1, 2025, and are non-refundable if cancelled within one week of the banquet. In the (we believe) unlikely event we are forced to cancel the Award Banquet, we will refund your reservation.