Scholarship Celebration Donor RSVP

Please complete the following form to register to attend the 2013 Scholarship Celebration event scheduled for Thursday, April 11, 2013.

The event will take place at the WKU South Campus located at 654 Campbell Lane. Registration begins at 5:00 p.m. and dinner begins at 6:00 p.m.

Please contact Jill Blythe at 270-745-5283 or email jill.blythe@wku.edu with any questions or concerns.

Last Name

First Name

Middle Initial

Email Address *

Telephone Number with Area Code *

Will You be in Attendance?

Yes
No

Name Preference for Name Tag

Guest Name Preference for Name Tag

Do you have dietary or handicap restrictions?

Yes, I have dietary restrictions
Yes, I have handicap restrictions
No, I have no restrictions

If So Please Explain

Any additional comments?