Dinner Reservation

Date: November 17, 2009
 

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In order to submit the form you must provide your full name, email address, and whether or not you are a member of the IMA or current student.  Your phone number is an optional item.

 

Dinner Reservation Form

  YES NO (Required)
Please enter your full name:   (Required)
Please enter your phone number:   (Optional)
Please enter your email address:  (Required)
Are you a member of the IMA?   YES NO (Required)
Are you a student?   YES NO (Required)
Investment
$22.00 Members
$15.00 Professionals between opportunities & Non-members
$11.00 Students
Do you require special accommodations or needs?   YES NO (Optional)
If yes, please specify your accommodations or needs:
Dinner is the following: Family style:
~ Chicken & fish
~ Baked potatoes
~ Soup & salad bar
Dessert: Variety of pies
 

 
 
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