List your full name as you would like it on your name badge

 	     First Name: 
              Last Name: 

 	        Company: 

	          Phone: 

  	         E-mail: 
  

           Work status:  Normal    Student   Unemployed   Retired
                      
    (Students,  retirees, and unemployed qualify for a discount on the dinner cost.
       Note:  Professor must arrange reservation for student to qualify) 
 
	       Member status: Member   Guest of Member  Non-member
        (The posted registration fee includes a $2 discount each for Section members
         and one guest.  The cost will be $2 more for non-members.) 

Is this the first Chicago Section local meeting you've ever attended?   no   yes


CAN YOU HELP?  We are looking for members attending the meeting that 
would be willing to pick up a non-driving member along their route and 
bring them to and from the meeting.  If you are willing to help out, then
if a non-driving or non-car-owning member along your way calls the office
looking for a ride, they will be given your name. Thank you.
Yes, I can offer a ride to the meeting to a member along my way: 

Meeting Information:
  
        Date of meeting:          
		   
        Please register at a later date for any future meeting  
  
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Choice of:

• Chicken Piccata
• Broiled White Fish
• Vegetarian Pasta Primavera with Alfredo Sauce

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Please note:  We have to make a commitment to the restaurant and order a meal for every reservation we receive.  If you make a reservation to attend a meeting and then do not show up without previously notifying us, we are still responsible to pay the restaurant for your meal.  To help our Section to defray this cost, you will be billed for the cost of the meal.  So please, if your plans change and you can not attend a meeting for which you have registered, let us know ASAP that you won't be attending.  Thank you.

Comments:

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