September, 2010 Meeting Registration Form

Use this form to register for our Tuesday, September 14, 2010 Chapter Meeting which will be held at 5:30 p.m.

Your Contact Details

First Name:
Last Name:
Email:           
Phone:         
We need your phone number in case there are problems or changes
Guest Email Addresses: (separate email addresses with a comma, please)

Meal Options

If you attend the meeting for dinner, please choose one of these dinner menus. Program only? Leave this section blank.

Chicken Florentine
Vegetarian entree: Vegetable Wellington

All entrees include a tossed green salad, warm rolls and butter, coffee (regular and decaf), tea, and chef's selection of dessert.

Notes: (e.g. special requests, meal choices for your guests)

Your Membership Status

Please select one. If you bring one or more guests, select only your status.

STC Phoenix Chapter Member
STC Member-at-Large
Southern Arizona Member
Student
Non-Member
Other Chapter Affiliation

Payment Method

Finally, please select how you wish to pay. Note that members pay $18 online and $20 at the door.

Credit Card (through PayPal)
Cash or Check at Meeting

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