Page 1

USU PROGRAM COUNCIL PRESENTS:

USU PROGRAM COUNCIL PRESENTS:

Wednesday, April 18th, 2012 at 7:00pm Outside in the Central Plant

Wednesday, April 18th, 2012 at 7:00pm Outside in the Central Plant

RSVP by 4:00pm on April 6th

RSVP by 4:00pm on April 6th

........................ PLEASE PRINT CLEARLY Name: ________________________________ Age: ______

........................ PLEASE PRINT CLEARLY Name: ________________________________ Age: ______

I am a (M / F) interested in (M / F)

I am a (M / F) interested in (M / F)

Daytime Phone Number: __________________ Contact Email: __________________________

Daytime Phone Number: __________________ Contact Email: __________________________

........................ Information Release

........................ Information Release

By signing this release form, you agree to have your name and email disclosed to participants of this event.You are also agreeing that you are of 18 years of age or older. USU Program Council is not responsible for contact between participants outside our informational email.

By signing this release form, you agree to have your name and email disclosed to participants of this event.You are also agreeing that you are of 18 years of age or older. USU Program Council is not responsible for contact between participants outside our informational email.

*Phone numbers will not be disclosed to participants. It is for USU Program Council use only.

*Phone numbers will not be disclosed to participants. It is for USU Program Council use only.

By checking this box, you are giving permission to have your photo taken during the event for marketing purposes.

By checking this box, you are giving permission to have your photo taken during the event for marketing purposes.

Signature: __________________________________

Signature: __________________________________

Date: __________________

Date: __________________

TURN IN ALL FORMS TO THE USU PROGRAM COUNCIL RM. 116. MORE INFO AT: WWW.PROGRAMCOUNCIL.ORG or CALL 562.985.4023

TURN IN ALL FORMS TO THE USU PROGRAM COUNCIL RM. 116. MORE INFO AT: WWW.PROGRAMCOUNCIL.ORG or CALL 562.985.4023

Speed Dating 2012  

Want to try your chance at love? Or at least maybe meet a few new friends? Speed Dating, entering its 10th appearance, has been a successful...

Read more
Read more
Similar to
Popular now
Just for you