2018    ASSESSMENTS
 
 
Lawrence-Spruill Family Reunion                     ASSESSMENT FORM 

 

Copy and Pace to print this form!


Your Name_______________________________
 

                                     Names of Adults 13 yrs  and older - $99.00
                                   
__________________________________       

__________________________________
 
__________________________________                   

__________________________________
                         
    
                                    Names of Children 6 - 12 yrs. - $49.00
 
__________________________________                   

__________________________________
 
__________________________________          

___________________________________
                                                                   

                                   Names of Children 5 yrs and under – FREE

___________________________________    

__________________________________

_________________________________                     

__________________________________
                                            

                                        Total Assessment Amount: $__________      



Please make and Mail
all checks and money orders to Imogene Roberts,                          M
ake all payments by June 30, 2018.

                                                       
                                      
                                                       Imogene Roberts

                                                       1955 Charbonier Rd  Apt #5
                                                      Florissant, MO 63031