KAPPA PSI PHARMACEUTICAL FRATERNITY

Gamma Upsilon Chapter

50th Anniversary Celebration

The event will be held on October 27, 2000 at the historic Stillwell Twiggs House.

The Stillwell Twiggs House is located at 134 South Fifth Avenue, Tucson, Arizona. (520-623-9123)

Dinner will begin at 6 p.m. and dancing will end by midnight.

Registration

_________________________________________
Name

______________________________________
Name of guest(s)

_________________________________________
Address

_________________________________________
City, State, Zip Code

_________________________________________
Phone (area code first)

_________________________________________
e-mail address

_________________________________________
Year graduated from the College of Pharmacy

Below please tell us anything special about your
Kappa Psi experiences. For example, did you hold
an office (and which one if so)? Were there any
events that made being a member particularly
enjoyable. We may use some of the comments for a poster we are making and want to recognize past officers.

_________________________________________

Payment, Purchase, and Donation Options

Dinner celebration @ $50/person x ___ = $ _______

Purchase 50th Anniversary Memorabilia

T-shirt - $17 Size M L XL
Polo shirt - $27 Size M L XL
Baseball cap - $13
Window decal - $2

Total Memorabilia = $ _____

For mailing to you add $3.00 for shipping

Sponsor the students (gift received for donation):

$25 (receive a window decal)
$50 (receive a baseball cap)
$75 (receive a t-shirt ) Size M L XL
$100 (receive a polo shirt) Size M L XL
$_______Other amount (multiples of gifts depending on amount above $100) Size M L XL

Funds paid to Kappa Psi are not considered tax-deductible contributions

Total sponsorship = $ ______

Total amount remitted = $ _________(sum of above)
Make checks payable to Kappa Psi, or

Visa/Mastercard (Circle)

Name on card__________________________________

Card number___________________________________

Exp. date________Signature______________________

For more information contact John Murphy at the address below, at 520-626-5730 (phone), or by e-mail murphy@pharmacy.arizona.edu
or contact Syble Reed, at (520) 326-6111, or by email sreed@pharmacy.arizona.edu

Mail this registration form to:
John E. Murphy, Kappa Psi 50th Anniversary
College of Pharmacy, P.O. Box 210207
The University of Arizona
Tucson, AZ 85721-0207