W I L L R O G E R S M E D A L L I O N A W A R D
2022 Will Rogers Medallion Award Banquet Ticket Order Form
Name: ________________________________________________________
Address: ______________________________________________________
Email: _________________________________________________________
I would like to order _______ Award Show Banquet tickets at $70 each
________ x $70 = ________ 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
Due Date & Refund Policy:
Reservations are due by October 9, 2022. In the (we believe) unlikely event we are forced to cancel the Award Banquet, we will refund your reservation at the last possible moment.