Luncheon/Event Registration
*Fields must be completed

*First Name:
*Last Name:
*Title:
*Company:
*Company Address:
*Company City:
*Company State
*Company Zip:
*Membership Status:	Select One Member Board Member Student Member Guest Student/Guest
*Phone:
Fax:
*E-mail:
Meeting Date:	2008-09-09 2008-10-14 2008-11-12 2008-12-09 2009-01-13
Attending:	Late Luncheon - Member ($21.00) Late Luncheon - Student Member ($15.00) Late Luncheon - Non-Member ($26.00) Late Luncheon - Student Non-Member ($21.00) Late Workshop - Member ($59.00) Late Workshop - Student Member ($0.00) Late Workshop - Non-Member ($79.00) Late Workshop - Student Non-Member ($45.00) Late Workshop & Luncheon - Member ($80.00) Late Workshop & Luncheon - Student Member ($15.00) Late Workshop & Luncheon - Non-Member ($105.00) Late Workshop & Luncheon - Student Non-Member ($66.00) Late Workshop & Luncheon - Board Member ($21.00)
*Lunch Preference:	Select One N/A Buffet Fruit Plate
Comments:
*Payment Information:		I would like to pay now by Credit Card.
		I would like to pay at the door.
		Past President/Sponsor/Speaker.
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