Annual Burns Supper
January 19, 2018
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 additional person, one name per line.
No seating assignments, this is open seating

1st Chieftain Chieftain Ian Purvis


Entree Selection

Indicate the number of each entree: Prime Rib . Chicken Cordon Bleu Salmon Lobster



Price

Indicate Number of Reservations Members...........................$55.00 per person
Non-Members..................$60.00 per person




To process your reservation press Submit