For reservations, please return this form with payment by June 19, 2026 to:
Cuba/Cuba-Rushford Alumni Association • PO Box 150 • Cuba, NY 14727
Your generous donations make the Community Service Awards possible
and may be given “in memoriam”
Name _________________________________________________________Class of _____________________
Name _________________________________________________________Class of ____________________
Address ___________________________________________________ Email _____________Phone# _____________________
Address ____________________________________________ Email _____________Phone# _____________________ (Please be sure to include first, last, and maiden)
Dinner Reservations: # of people__________x $27.50 = ____________
Class of 76 # of people__________x Free
Guest # of people__________x $27.50 = ____________
Dues 2026 - 2027: # of people__________x $ 5.00 = ____________
50-50 Raffle (3 for $5) # of tickets___________ at ____________ ____________
Donation “in memory of”____________________________________ $ ____________ (name) Total $ ____________ form enclose
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