Please fill out the following form and hit the continue button when you are finished. (* denotes a required field).
Name: *
Company Name:
Address: *
City: *
State: *
Zip: *
Phone Number (999-999-9999): *
Email: *
Number of Reservations @ $275 per person:
Type of entree: #
Guest 1 select Your Entree: Choose Your Entree Filet Salmon Vegetarian
Guest 2 select Your Entree: Choose Your Entree Filet Salmon Vegetarian
# For more than 2 guests, please contact the advancement office at 815-740-5045 with your entree selections.
Raffle tickets are $50 each or 3 for $100
Number of Raffle Tickets (if no raffle tickets please enter 0)
*Please make sure you remember (write down) the number of tickets and cost, you will need the information later.
Avoid the long lines and fill out the information below to pre-register your credit card for the silent auction.
Type of Credit/Debit Card: Type of Credit/Debit Card American Express Discover Master Card VISA
Credit Card/Debit Card Number (9999 9999 9999 9999):
Expiration Date: (99/99):