Phi Beta Kappa Alumni Association of Northeast Florida


Spring Reception and Banquet, Thursday, April 18, 2013, 6:00 PM

Timuquana Country Club

4028 Timuquana Road


Reservations Are Due By Thursday, April 11


Please mail this form and your check, made payable to PBK Alumni Assn. of NE Florida, to:           

                                                        John F. Callender, President

                                                        1301 Riverplace Boulevard, Suite 2105

                                                    Jacksonville, Florida 32207-9019


Your email address:___________________________________


Where and when were you elected to PBK?_____________________________________


The Banquet:   Please indicate choice of entrée by the name of each person in your party:

 Name(s):_________________________________ Chicken Marsala ___Grilled Salmon____


_________________________________    Chicken Marsala___ Grilled Salmon____


_________________________________    Chicken Marsala___ Grilled Salmon____


           _________________________________    Chicken Marsala___ Grilled Salmon____


The PBK Alumni Association Scholarship Fund:

Please consider giving as generously as you can to the scholarship fund to help talented students fulfill their educational goals.  You may either include everything in one check or send a separate check.  Gifts from friends and guests are not expected but welcome.  Contributions to the scholarship fund are tax deductible and a receipt will be provided.

                                 Amount of contribution to the scholarship fund: $__________


Membership dues for 2012-2013:

If you are a Phi Beta Kappa and have been a member of the Association but did not renew your membership last fall, or if you are not a member and would like to join the Association, please do so now.

                                 Membership @ $35:                                $__________

                                 Dinner @ $40 each:                                 $__________

                 Total amount enclosed:                        $__________