Butler County Pheasants Forever
3255 Symmes Road
Hamilton, OH 45015
Banquet ticket purchasers receive a one year membership in either P.F. or Q.F.
Better yet, receive a dual membership for just $20 more.
_______ I wish to become an Underwriter for $350
Underwriters only, please circle shirt size for future reference S M L XL XXL XXXL
_______ Please send me tickets for _______ couples at $100 per couple
_______ Please send me an individual ticket for $65
_______ I cannot attend, but I wish to renew my membership for $30
_______ Please send me _______ Gun Raffle ticket(s) at $5 each.
_______ I would be interested in serving on your chapter’s committee. Please contact me.
_______ I prefer a Pheasants Forever membership
_______ I prefer a Quail Forever membership
_______ I want a dual membership in both P.F. and Q.F. for an additional $20
_______ New membership _______ Renewal Membership _______ Change of Address
Other levels of Membership available and their benefits
______ $50 Rooster Booster Cap and decal signifying Rooster Booster Membership ($20 FMV)
______ $100 Magnum PF Engraved Leatherman with Case ($32 FMV)
______ $250 Sponsor Lapel pin and Sponsor Edition Print of the Year ($130 FMV)
______ $1,000 Life Framed Life Member Certificate w/ Gold Pin
and recognition in Annual Report
______ $10,000 Patron Patron plaque, PF Jacket
and recognition in Annual Report (Payment plan available)
_______ I am enclosing a check for $______________ payable to Pheasants Forever.
_______ Please charge the above to my _______ Visa _______ Mastercard
Account # _____________________ Expiration Date ______________
Signature of card holder ______________________________________
Please send my tickets to:
Name ___________________________________________________________
Address ___________________________________________________________
City ______________________________State__________Zip__________________
Email address ______________________________________________
Phone number (home) ________________________________________
Print and send this completed form to:
Pheasants Forever
3255 Symmes Road
Hamilton, OH 45015
Please indicate your seating preference on this order form. Thank you.
Seating Reservations Form
The tables at our banquet seat 8 people. We strive to seat you with your friends and family members. In order to do
that, would you please indicate whom you would like to have seated with you. We will reserve your seating, and tell you
your table number when you arrive at the banquet. Thank you.
1. _______________________________
2. _______________________________
3. _______________________________
4. _______________________________
5. _______________________________
6. _______________________________
7. _______________________________
8. _______________________________
