Simmons Cancer Institute at SIU School of Medicine

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Registration - SIU Men's Night Out 2012

Thursday, November 8, 2012
Presented by Simmons Cancer Institute at SIUMNO


Men only - No Women or boys under 21 allowed
Tickets are $15 each or $100 each for Evening with Cardinal Legend and are nonrefundable.

Tickets may still be purchased online but will no longer be mailed ahead of the event. They will be available at any of the entrances to Springfield High School by providing the name the tickets are held under or purchased by.

 


Contact Information
* Required Field      
First Name *
Last Name *
Mailing Address * City *
State * Zip Code *
Phone*
area code, prefix, number
Email
Special Needs
Please indicate any special needs that you (or your guest) may have:
 
  Men's Night Out Tickets
  Dinner • Health Screenings • T-shirts • Door Prizes • Grilling Demonstrations
 
Number Attending  
 $15 per person