2017 Moravian College Hall of Fame Induction Ceremony Registration - Moravian University

Friday, November 3, 2017

Reception begins at 6:00 p.m. - Johnston Hall

Dinner begins at 7:00 p.m. - Johnston Hall

RSVP Deadline EXTENDED - Friday, October 27, 2017

Email address *

First name *

Last name *

Address 1

Address 2

City

State

ZIP Code

Cell Phone Number *

Are you a Moravian graduate? If yes, please list graduation year

If you are married, what was your maiden name?

Are you a member of the Moravian College Hall of Fame?

If yes, please answer next question as well

Yes

What year were you inducted into Moravian's Hall of Fame?

Complete Buffet Dinner includes Beef (flank steak), Chicken (breast with bordelaise sauce), and Vegetarian (mushroom ravioli).

Cost $40 per adult

Children Ages 6-14 - Option 1 - Buffet Dinner - $25

Children Ages 6-14 - Option 2 - Chicken Fingers/Fries Dinner - $15

Children Under Age 6 - Chicken Fingers/Fries Dinner - no charge
*Please note: This event is approximately 3.5 hours from beginning of the reception until the conclusion

Are you being inducted into the Hall of Fame in 2017 or a member of the 2001 women's cross country team? *

If "Yes", please answer the following question

Yes No

Inductees - Please list your guest's name

All inductees are allowed one guest to accompany them (free of charge)

Number of Additional Adults at $40 per person *

This excludes your guest. Please DO NOT include those who are just attending/not eating.

Please list names of attendees

Please list graduation years if any attendees are Moravian graduates as well as Maiden name

Number of Children 6-14 for Option 1 at $25 *

Please list names of attendees

Number of Children 6-14 for Option 2 at $15 *

Please list names of attendees

Number of Children Under 6 at no charge *

*Please note: This event is approximately 3.5 hours from beginning of the reception until the conclusion

Please list names of attendees

Would you like to make an additional donation to help support the Moravian College Hall of Fame?

If so, please select an amount from the list below

Thank you for your support of the Moravian College Hall of Fame

There will be a $3.00 convenience fee to submit this online form.

* required field