CFN 2007 Founders Day
February 3, 2007
Newport Sports Museum
100 Newport Drive
Reception 5 PM - Dinner 6:30

Name ________________________________________________________________

Address ______________________________________________________________

City _______________________________ State _______ Zip ___________________

Phone (______) ____________________ Email _______________________________

Number of people attending with a CFN member @ $40 each __________

Number of non-members attending @ $50 each __________

Mail completed form and check payable to Californians for Nebraska to:

Eloise Heaton
860 Morningside Drive #C219
Fullerton, CA 92835

If paying by credit card please fill out the information below:

MC VISA (circle one) 16 digit card number ____________________________________

Expiration date (MMYY) ______________

*** Please mail before January 27th ***