Enrollment Form
2006 oba Occidental businessperson of the year award dinner
Tuesday | September 12, 2006 | 6:30 PM - 9:30 PM
Information | Printable Form | Online Form
Class Year: _________
Name:__________________________________________________
Company:_______________________________________________
Industry:________________________________________________
Title:___________________________________________________
Address:________________________________________________
City/State/Zip:___________________________________________
Work Phone: _____________________________
Home Phone: ____________________________
E-mail:______________________________________________
Guests Names *
___________________________________________________________________________________________________
(* list class year if Oxy alum)
Number of Tickets:
OBA Member & One Guest _____ x $ 65.00 = $ _____
Non-Members _____ x $ 85.00 = $ _____
Membership Dues* _____ x $ 50.00 = $ _____
Total Enclosed $ _____
* Please complete and return the OBA membership form.
Method of Payment:
____ Check enclosed (Make payable to "Occidental College").
____ Charge my VISA or MasterCard (circle one).
Card # ______________________________
Expiration Date _______________________
Name on Card ________________________
Signature ____________________________
RSVP Deadline: September 6th. Enclose your business card. Mail this reservation form to: Occidental College, Alumni Association M-11, 1600 Campus Road, Los Angeles, CA 90041 or fax it to 232.244.1261. For more information call Alumni Relations at 323.259.2601 or email deb@oxy.edu.
Occidental College | Alumni Association | Contact Information
This page was last updated on August 18, 2006