November 2011 Meeting Registration Form

Use this form to register for our Thursday, November 10, 2011 Chapter Meeting which will begin at 5:30 p.m.

Registration deadline is November 8, 2011 at 7 p.m.

Note that our meal will be served buffet-style, thus no meal selection is necessary. Refer to the meeting notice for meal details.

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)

Notes: (e.g. special requests)

Your Membership Status

Meeting price is the same for all attendees, but please select one of the following for our records. If you bring one or more guests, select only your status.

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

Dinner Meal Choice

Buffet Dinner and Program
Program Only

Payment Method

Finally, please select how you wish to pay. Note that all attendees pay $25 online or $27 at the door, or $15 for program-only.

Credit Card (through PayPal)
Cash or Check at Meeting

To reload and receive a new challenge for you to type in the field provided, click the circular arrows located under the "words".

 

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