Installation Dinner
January 5, 2019
Reservation Form


Reservations Required - No ticket sales at the door

Please fill in the blanks, using your tab key to move between fields.
Type first and last name(s) of each person you are making a reservation for.

 

Name
Address
Address
CityState ..Zip -
Phone( ) .Email

Additional Reservations and Comments
Please list first and last names
of each person, one name per line.
Also use this space to request seating with others
or to send a comment to
Ian Purvis.


Entree Selection

Indicate the number of each entree: Filet of Beef . Roasted Chicken Seared Salmon Filet Vegetarian Paella



Price

Indicate Number of Reservations Member & Partner..................$30.00 per person
Other Guests............................$30.00 per person




To process your reservation press Submit