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Seniors_Fall2019_web

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64 Fall 2019 Cary Senior Center Participant's Last Name ________________________________ First Name ______________________________________ Class Class/Workshop Day Date(s) Time Fee* Code Title _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ _____________ __________________________ ________ _______ _______ ___________ Transfer this total to the other side: $ ________ Cary Senior Center Memorial Garden Plaza Cary Senior Center Memorial Garden Plaza Remem- ber a loved one with a gift to Cary Senior Center's Memorial Garden Plaza. With your $100 or more donation, an engraved brick will be placed in the Memorial Garden Plaza, surrounded by beautiful gardens and a relaxing fountain. This tax-deductible contribution will show your dedication to Cary Se- nior Center, while honoring or memorializing a loved one, friend or yourself! Fill out this form and return it with a separate check for $100 or more, payable to: Friends of the Cary Senior Center, Inc. Call (919) 469-4081 for more information. Please print text in the spaces provided below. There is a maximum of 3 lines and no more then 17 characters per line (characters include letters, dots, dashes, spaces, numbers, etc.). Please use a separate form for each brick. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ If this is a gift, please acknowledge to: Name:____________________________________________________________ Address:_________________________ City/State:____________ Zip:________ Registration Form

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