To:  Sharla.Rucker@twc.state.tx.us
From:  [email]
Subject:  Sign-Up for Retreat Pedicure

I would like to request a pedicure at the following times:

NAME:    [name]

E-MAIL ADDRESS: [email]

OFFICE:  [office]

FIRST CHOICE:  [time_1]

SECOND CHOICE:  [time_2]

THIRD CHOICE:  [time_3]