FRANCES FLEET DEPOSIT FORM

Name:___________________________________________

Address:_________________________________________

                 _________________________________________

Daytime Phone:(____)_____________________________

Number in party (____)
Names of other members of party:

1)______________________________________________

Address:_________________________________________

Phone(____)___________________

2)______________________________________________

Address:_________________________________________

Phone(____)___________________

3) ______________________________________________

Address:_________________________________________

Phone(____)___________________

5)______________________________________________

Address:_________________________________________

Phone(____)___________________

6)______________________________________________

Address:_________________________________________

Phone(____)___________________

Date of trip: ___/___/___

Type of trip _____________________

If you would like confirmation of deposit, check here____

MAIL (with deposit) to:

FRANCES FLEET
P.O. BOX 3724
PEACEDALE RI 02883