Sponsor: Raleigh Bottle Club
Date/time: Saturday April 28, 2001 9:00am-3:00pm (setup times below)
Place: NC Military Center on Reedy Creek Road in Raleigh NC
The undersigned below agrees to the following terms:
Raleigh Bottle Club
PO Box 13736
Durham, NC 27709
Phone: (919) 789-4545
Fax: (919) 781-9668
Email: raleigh@antiquebottles.com
Signature (agreeing to terms above): __________________________First/Last Name: ______________________________________________
Street Address: _________________________________________
City/State/Zip: __________________________________________
Phone number (optional): _____________________________
Email Address (optional): ____________________________
Badge names (2 per dealer) 1: ____________________ 2: __________________