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Chapter Member Pre-Paid Registration Form
Please Respond At Least Two Weeks
Prior To Event
Make Checks Payable to:
Mail to: Phyllis M. Eckert, Secretary
Chicagoland Chapter #3
736 S. Berkley Ave.
Elmhurst, IL, 60126
Mart Admission
Reserve ____ at $2.50 each
Amount:
$________
Mart Table Rental
Reserve _____Tables at $10.00 each
Amount $ ________
(Table Rentals Require the
purchase of a mart admission)
Luncheon
Reserve ____luncheons at $12.50 each
Amount $ _______
______________________________________________________________________________
Total Amount of
Check
Amount $ ________
Name:
______________________________________NAWCC# ______________
E Mail
Address_____________________________
Additional Names:
____________________________________________________