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2023 Will Rogers Medallion Award Banquet Ticket Order Form

* Reservations due by October 1, 2023

Name: ________________________________________________________                                                                    

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 due by October 1, 2023. In the (we believe) unlikely event we are forced to cancel the Award Banquet, we will refund your reservation.

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