2012 Senior Awards Banquet Ticket and -or Honor Cord Order Form
Alpha Lambda Delta
Liberty University Chapter
1971 University Blvd, Lynchburg, VA 24502
2012 Alpha Lambda Delta Honor Cord Order
Complete Name upon Initiation____________________________________________
Married Name if Married After Initiation_____________________________________
LUID#________________ Year Initiated_____________ LUO or Resident (circle one)
Current Email Address___________________________________________________
Mailing Address: _______________________________________________________
I am a May 2012 Candidate for Graduation and wish to order one (1) Alpha Lambda Delta Honor Cord @ $8.00. Please circle one…
I understand that my ALD honor cord will be mailed to me at no additional charge to mailing address furnished above.
Please do not mail my honor cord and I will pick it up when I arrive on campus for graduation
I would like to order the following Senior Awards Banquet Tickets (enter number of each entrée ordered….
(Entrees are: Beef Tenderloin, Chicken Alfredo, Vegetarian Lasagna)
Entree for Myself____________________
Entree(s) for Guest(s)____________________________________________________________
Payment Enclosed: (checks and money orders made payable to Alpha Lambda Delta)
Check #____________ Money Order # (U.S. funds only) _____________________
Circle Credit Card Type: American Express, Discover, Master Card, Visa
Credit Card #_________________________________________________
Orders may be mailed or delivered to the following address: fax and telephone orders accepted only if using credit card.
Mrs. Bessie E. Grayson, Administrative Advisor
Alpha Lambda Delta Honor Society
DeMoss Hall 2172
1971 University Blvd
Lynchburg, VA 24502
Telephone: (434) 582-2080
We will email you an acknowledgment upon receipt of your order form and payment.