Registration for GJBSAR OCTOBER 15TH Meeting w/Dinner

Registration for GJBSAR October 15th Meeting

Please register for the upcoming October 15th GJBSAR Meeting and Dinner. Location and time: St. Luke's Union Church, Bloomington, at 6 pm. Please fill out the form to reserve your spot for the meeting and make the appropriate payment for the meal provided, credit card or bank. Dinner menu to be announced (* = required field).
Your Full Name

First NameLast Name
Your Email Address
example@example.com
Your Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Number of Guests Included
Number of Chef salads (optional)?
This count includes you and guests. 0 indicates none, all eating dinner menu.
Names of Guests
Note: Please separate the guests by commas.
Additional Comments
Please note: Payment for members and guests are $17 each. We would appreciate making payment via credit card or bank transfer However, we will also except payment by cash or check at the door.
Payment by?

Credit card or bank transfer - $17

Fee for the meeting w/dinner on October 15th

$17.00 Quantity

Total

Payment Methods

Debit or Credit Card

ACH Bank Transfer

Registration for GJBSAR October 15th Meeting