2012 Senior Awards Banquet Ticket and -or Honor Cord Order Form
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 )) _____________________ 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.
Administrative Advisor Telephone : (434) 582-2080
Fax: 434-582-2113
We will email you an acknowledgment upon receipt of your order form and payment.
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