The Wordsworth-Coleridge Association Lunch - Payment by Check

You are welcome to make payment by personal check for the Wordsworth-Coleridge Association Lunch.

Please print out this page and mail it to the address shown below, together with your check or money order.

 

Please remit payment of $40.00 USD per person for the lunch. Canadian residents, please remit $52.00 CAD per person.

 

Please make your check payable to: John Clare Society. Add "WCA Lunch" in the memo line. Thank you for your reservation!

 

Your Name: ___________________________________   

Address: ______________________________________

______________________________________________

______________________________________________

E-mail: ________________________________

 

Please list the names of any additional guests: ___________________________________________

 

RETURN THIS FORM TO:

Dean James McKusick

UMKC Honors College

5030 Cherry St, Rm 424

Kansas City, MO 64110-2232

U.S.A.

 

This event is co-sponsored by the John Clare Society of North America. Founded in 1997, the John Clare Society of North America is organized and operated exclusively for charitable, literary and educational purposes within the meaning of Section 501(c)(3) of the United States Internal Revenue Code.  Donations by U.S. residents are tax-deductible to the extent provided by law.

 

NOTE: Payments by check are acceptable only in U.S. or Canadian currency. Other patrons are encouraged to make payment by credit card - see details on the WCA Lunch page.