Member Registration for AIDC 100

Annual Meeting plus Reception and Dinner

November 2, 2010

For those wishing to register for the AIDC 100 annual reception/dinner and/or the members annual meeting (both on November 2nd), please complete the following:

Members Registration

Last Name
First Name
Telephone:
Cell:
Email:


MEMBER ATTENDEE:

  
Attending Annual Meeting on November 2nd?
 (no charge)		  
Attending Open Bar Reception and Dinner on November 2nd at McCormick & Schmicks?
(cost: $60)		  


MEMBER'S SPOUSE/ SIGNIFICANT OTHER:

Spouse/Significant Other Attending Open Bar Reception and Dinner on November 2nd at McCormick & Schmicks?
 (cost: $60)

  
If yes, please provide name:


MEMBER'S GUEST:

  

Guest Attending Open Bar Reception and Dinner on November 2nd at McCormick & Schmicks? (cost: $60)

  
If yes, please provide name:

Please click submit and then you will have the option of paying with credit card (PayPal) or paying by check.