Registration Form

Founder's Day

Muhammad Farms

July 2,3 & 4, 2010

Bronwood, GA

Name:______________________________________ Address:____________________________

City:_______________________________State:________________________Zip:____________

Phone:_____________________Fax:____________________

E-mail:_______________________

Number                                                                Dollars

______Adults---$15 Registration                      __________

_______Children/Students---$5                            _________

                                                                            Total   _________

Meals:    Vegetarian or  Fish/Turkey                

Adult---$10        Children---$5             

Friday Fish Fry # Adults___________  #Children_______

 Saturday Dinner #Adults_________      #Children_______

 

Make check or money order payable to the "Three Year Economic Sav. Prog."

For further information call Dr. Ridgely or Sis. Anne Muhammad at (229)995-6619 fax:(229)995-6771 or email Dr. Ridgely at drridge@bellsouth.net

(Print out, fill out and return to

Ministry of Ag. Conf.

 2569 Southpoint Rd

Bronwood, Ga 39826)