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The 16th Annual Mondale Award & Scholarship Dinner Gala
Please call us if you have any questions! Phone: 612.379.2393. If you are mailing a check to us for your ticket(s),
the address is: 43 Main Street SE / EH-131 / Minneapolis MN 55414.
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First Name
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Last Name
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Email Address
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Address
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Phone Number
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Are you a JASM Member?
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Payment / お支払い方法
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$100 for members / $125 for non-members
Check Payable to "JASM" (Please send your check to the JASM office) by October 25, 2013
Credit Card (Please use the paypal link available on the Mondale Award Dinner & Gala page on the JASM website)
Would you prefer a vegetarian meal? / ベジタリアンの食事をご希望ですか？
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If you are bringing any guests, please write the number of guests & their names below and if he/she prefers a vegetarian meal.
ご一緒に参加される方がいらっしゃいましたら、以下にご自身を除いた人数とお名前とその方がベジタリアンの食事を希望されるかどうかをご記入ください。
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