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MPA Event Registration

Michigan Pharmacy Foundation Tail Great Party
Oct. 15, 11 a.m., Golden Rose, Okemos. Join friends, colleagues and archrivals at the Michigan Pharmacy Foundation's Tail Great Party. Enjoy a festive tailgate party prior to kickoff of the Michigan State vs. U of M football game, then sit back and root on your favorite team in comfort, indoors on big screen TVs. Take part in other fun events that will be held throughout the day. Grab a Wolverine or Spartan friend, and have them join you for this fun-filled event. Casual dress—Maize & Blue or Green & White. Children 10 and older are welcome, and special games and contests will be held especially for them.

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Day time Phone *

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Registered Member
Non Member

Fields Marked with an *asterisk are required.

Tickets ($25 of each individual ticket is tax-deductible. Student and children tickets not eligible for tax deduction.)

Member Cost Non Member Cost
Individual
$ 95.00 $ 95.00
Couple
$ 170.00 $ 170.00
Children
$ 30.00 $ 30.00
Table of Eight
$ 600.00 $ 600.00
New Practioner
$ 75.00 $ 75.00
Student
$ 30.00 $ 30.00

T-shirts

I am a U of M alumnus (designate shirt size and # needed if registering for more than one attendee)

I am an MSU alumnus (designate shirt size and # needed if registering for more than one attendee)

I want to be an honorary U of M alumnus for the day (designate shirt size and # needed if registering for more than one attendee)

I want to be an honorary MSU alumnus for the day (designate shirt size and # needed if registering for more than one attendee)

First Name	*
Last Name	*
Nick Name
Member ID
Employment	*
Title
Mailing Address	*
City	*
State	*
Zip	*
Day time Phone	*
Fax	*
Email	*