NOV. 20 LEE’S PLACE 2017 529 BLOOR ST W 8 12 P.M. MIDNIGHT Please fax or email back to Stephanie O’Brien at 416-445-2644 or [email protected] Number attending ____ x $15 = $ _______ Yes I want to Jam with Brian: ____ songs x $25 = $ ________ What would you like to sing and/or play? ___________________________________ What musical instrument do you play? _____________________________________ TOTAL $ Full Name: _________________________________________ Signature: ________________________ Credit Card: VISA MasterCard Other ___________________________________________ Credit Card Number: ________________________________ Expirty Date: ____________ Validation Code: _______ (Reverse of Card) JAM WITH A PAST PRESIDENT The Ontario REALTORS Care ® Foundation in Celebrating More Than 40 Years of Giving Back.