Reservation 2007 W3R-USA June Meeting

Reservation Form
(Please print and mail)

W3R-USA June Meeting
Friday-Saturday, June 22-23, 2007

NAME____________________________________________________________________

         ADDRESS________________________________________________________________

         TOWN ________________________________ STATE __________ ZIP ______________

         PHONE __________________________

         E-MAIL ___________________________________________________________________

SATURDAY BOX LUNCH: Choose one of the following sandwiches

# ________Croissant with grilled chicken, sliced mango, red onion,
fresh cilantro and baby greens

# _______ Focaccia Bread with sliced pork, red onion, thinly sliced
orange, baby greens and spicy mayonnaise

         # _______ Italian roll with portabella mushroom, roasted red peppers,
                             fresh basil, baby greens and balsamic vinaigrette dressing

        Marinated green bean salad, red grapes, chips and a brownie will be
        included in each box lunch. Drinks will be provided.

FRIDAY DINNER, $25 per person $_____________

SATURDAY REGISTRATION, $35 per person $_____________

TOTAL $_____________

Make checks payable to W3R-USA. Send to:

Carl Nittinger
W3R-USA Treasurer
130 Walnut Street
Haddonfield, NJ 08033

__________ I need a ride from train to hotel
__________ I need a ride from hotel to Monmouth