---------- Print this page and mail with your check ----------

AMC CT Chapter 
Annual Gathering Reservation Form
 
Saturday, November 15, 2008

Dinner and Evening Program
AMC Members $40.00
Non-Members $45.00
Workshops Only $10.00

Dinner Choices

Vegetable Lasagna Served with Vegetable Medley and Garlic Mashed Potatoes
Sliced Stuffed Chicken Breast
Baked Scrod

  First and Last Name AMC Member # Meal Choice Amount Enclosed
1.
2.        
3.        
  Total payable to "AMC CT CHAPTER"  

No confirmation is sent. Pick up your name badge at the Registration Table. This is your admission and dinner ticket.

Reservations must arrive by October 24th. CANCELLATIONS: No refunds after November 12th.
Dinner Price Includes Evening Program Mail this form with your check to:

Your Phone #______________________________

Your Email Address_________________________

  Lori Stethers
15 Banbury Rd
West Simsbury, CT 06092