---------- Print this page and mail with your check.  Make check payable to AMC CT CHAPTER ----------

AMC CT Chapter 
Annual Gathering Reservation Form
 
Sunday, November 12, 2017 at the Saint Clements Castle, Portland, CT

Afternoon Workshops, Dinner, and Evening Program
  AMC Members  $45.00
  Recognized 2017 Volunteers  $25.00 (see below*)
  Non-Members  $50.00
Workshops only (no dinner or evening program)
  AMC Members and Non-members $15.00

Dinner Choices
Grilled Angus Sirloin
Chicken Francaise
French Pork Loin Chop
Eggplant Rolotini
each served with accompanying vegetable and dessert

  First and Last Name AMC Member? Meal Choice (circle one) Amount Enclosed
1.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
2.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
3.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
4.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
5.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
6.
Yes / No Sirloin / Chicken / Pork Loin Chop / Eggplant / Workshops only
  Total payable to "AMC CT CHAPTER"  
Please provide a method to contact you in case we
have any questions about your reservation:
Mail this form with your check to:


Phone #______________________________

Email Address_________________________

  Cindy Butts
AMC CT Chapter
17 Bridlewood Rd
South Windsor, CT 06074



RESERVATION DEADLINE: Reservations must arrive by November 1st.
CANCELLATIONS: No refunds after November 1st.
No confirmation will be sent. Please pick up your name badge at the Registration Table upon arrival.

* Recognized volunteers are those notified by one of the chapter committees as having met a prescribed level of service to the chapter membership. Eligible leaders have received an email from their committee about this award.