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 50% 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
Meeting Information:
  
        Day of meeting:             
        Please register at a later date for any future meeting  
  
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Dinner Selection:   Medallions of Beef    Salmon     Pasta Primavera

• Seared Medallions of Beef with Burgundy Reduction Sauce, or
• Broiled Atlantic Salmon with Bearnaise Sauce, or
• Pasta Primavera

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Comments:

For questions or comments, please contact Milt Levenberg at:   milt@chicagoacs.net