Reservation Form for
"Cambridge Historical Society Celebrates MIT"
Sunday, May 18, from 2:00-4:30 p.m.

Please print out and complete this form and send with payment before May 9 to the Cambridge Historical Society, 159 Brattle Street, Cambridge, MA 02138. Your name(s) will be placed on a list by the door. Tickets will not be mailed. See map and directions.

The event is is $75 for 1 person, $150 for 2 people, and $250 for 4. Please call CHS at 617 547-4252 if you wish to purchase more than 4 tickets. Amounts of $10 per ticket are tax deductible. Your contribution supports the mission of the CHS and our stewardship of the Hooper-Lee-Nichols House.

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Name(s) for the attendees list and as you wish it to appear in the Program Book:

____________________________________

____________________________________

I wish to remain anonymous in the Program Book: ( ) yes ( ) no

NUMBER OF PEOPLE IN YOUR PARTY____

TELEPHONE_________________________________

ADDRESS__________________________________

E-MAIL_____________________________________

AMOUNT ENCLOSED______________

I/we cannot attend but wish to make a tax deductible contribution of $_____ to the CHS.