28 February Panera Bread Lunch

Last Name / Nom de Famille

First Name / Prénom

Service Number / Numéro de Service

Rank / Rang

E-mail

Phone Number / Numéro de Téléphone

Member Status / Statut du Membre

Meal Option / Choix de Repas

Turkey Bacon Bravo Ham & Swiss Mediterranean veg boxes

Cost / Coût

Member - $5 Non-Member - $15

Acknowledgement that $5.00 will be deducted from the members pay if the meal is not picked up between [date / time] in the Oak Bar

YES / Oui I AM A RESERVIST/ASSOCIATE - MY ACCOUNT WILL BE CHARGED $5 THAT I WILL PAY VIA E-TRANSFER OR IN THE CLERKS OFFICE

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