You are on page 1of 1

HOST FAMILY NAME

HOSTED STUDENT NAME


Plese fill out and bring to May Orientation ALONG WITH PAYMENT.

HOST STUDENT SHIRT SIZE FREE

HOST PARENT SHIRT SIZE $5.00 EA

HOST PARENT SHIRT SIZE $5.00 EA

HOST SIB. SHIRT SIZE $5.00 EA

HOST SIB. SHIRT SIZE $5.00 EA

PICTURE CD YES NO CIRLE ONE FREE

PHONE #

E-MAIL
Make and Mail checks to Ron Combs 2134 SE 60th Ave, Portland, Oregon 97215-4072
(H503-777-8117) E-Mail r1p2combs3@aol.com If you have already oredered please send in your
check. Shirts will be ready for you at Lentz Park at end of stay. Please mail or bring this form and
check to Ron Combs at Pre-Departure Orientation in May.

You might also like