Tribute to Women Luncheon

Registration Form

 

Mail to:                                                                                  Checks Payable to:

Mary Mayo, VP Finance                                                    TFRW PAC

875 Heathington Road

Weatherford, Texas 76088 

 

Club Name: _________________________________________________________________

(no acronyms please)

 

For Club members who wish to be seated together:

1.      List all members attending from your club (please list Honorees first)

2.      Mail form with your bundled checks attached

3.      Registration:   $ 59.00 per person 

 

Please Note:  Seating assignments will be on a “first received” basis.  Luncheon tables accommodate 10.  If your table is not full members from other TFRW clubs will be assigned to sit with you.

 

Clubs may nominate up to 4 Honorees – please list below:

*If honoring someone that cannot attend the event, please fill out the separate form provided

 

Name of Honoree: ____________________________________________________________

Address: _____________________________________________________________________

Phone: ______________________________________________________________________

E-mail: ______________________________________________________________________

Occupation:  __________________________________________________________________

            pmt by ck # ________

                               

Name of Honoree: ____________________________________________________________

Address: _____________________________________________________________________

Phone: ______________________________________________________________________

E-mail: ______________________________________________________________________

Occupation:  __________________________________________________________________

            pmt by ck # ________

 

Name of Honoree: ____________________________________________________________

Address: _____________________________________________________________________

Phone: ______________________________________________________________________

E-mail: ______________________________________________________________________

Occupation:  __________________________________________________________________

            pmt by ck # ________

 

Name of Honoree: ____________________________________________________________

Address: _____________________________________________________________________

Phone: ______________________________________________________________________

E-mail: ______________________________________________________________________

Occupation:  __________________________________________________________________

            pmt by ck # ________

 

 

Additional Club Members, Elected Officials or Guests attending – please list below:

Please feel free to make additional copies for additional attendees

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

Name: ______________________________________________________________________

            Please circle one:          Club member                             Elected official                           Guest

 

Address: _____________________________________________________________________

Phone:  _____________________________________________________________________

Occupation: __________________________________________________________________

      pmt by ck # _______

 

 

Submitted by:

Name:  __________________________________________  Phone # ____________________