Chess Class

Registration (instructors through the St. Louis Chess Club)

Mondays

3:30-4:30

Novice and experts

wanted.

Begins 1/27/14

Call 314-961-1500 to

register by 1/23/14

Friday, January 24, 2014 9:00 – 10:00 a.m.

Miriam School

Clayton

High School

St. Mary’s

High School Lafayette

High School Bishop DuBourg

High School

Parkway South

High School

Quiz Master Sponsorship Includes ten event tickets, recognition on screen & on quiz sheets for 10 rounds

Round Sponsorship Includes recognition on screen & on quiz sheet for one round

Single event ticket

I cannot attend but please accept my tax-deductible contribution.

$500.00

Check enclosed (made payable to Miriam Foundation)

Signature

Method of Payment (check one)

Name

Address

Phone Email

______@

______@

Thank you!

=$___________

=$___________

=$___________

=$___________

=$___________

=$___________

Table Sponsorship Includes ten event tickets ______@

$ 25.00

$200.00

$250.00

______@

“Friends of Miriam” annual membership Valid for one year from date of purchase

Total:

______@

$ 45.00

“Friends of Miriam” lifetime membership ______@

$ 500.00

=$___________

=$___________

=$___________

Credit Card # Security Code Exp. date

Beer available for

donation!!!

Soda, water, and

snacks provided!

Please return form and payment by Friday, February 14th to:

Miriam: The Learning Disability Experts ● 501 Bacon Avenue ● St. Louis, MO 63119

OR fax to (314) 962-0482

MasterCard Visa Discover

Proceeds benefit the

Miriam School

Scholarship Campaign!

VIP Table - only 4 available! Includes ten event tickets, a table at the front of the room, ten

mulligans, and inclusion in all games (heads or tails, etc.) for the entire table. $1,000.00

______@

Live Auction item: 2bd, 2ba condo on Fort Myers Beach, FL

EXTRA fun including: Silent Auction 50/50 Raffle Wine Pull Balloon Pop Heads or Tails

Friends of Miriam is the membership branch of our organization, and is comprised of individuals who are committed to improving the lives of children with learning disabilities. Our Friends are a diverse group of parents, relatives, professionals, and community members with a variety of backgrounds and expertise. They seek to increase public awareness and support of Miriam by planning and participating in a variety of fundraising events.

Doors open at 6 pm. Trivia begins at 7 pm.