Print this page, fill it out, and fax it to MSPC Reservations to 847-266-8740

 

_______________________________________________________________________

Name

_______________________________________________________________________

Address

_______________________________________________________________________
City, State, Zip

_______________________________________________________________________

Phone Number

_______________________________________________________________________

Fax

_______________________________________________________________________

E-Mail

 

I will pay by:

_____ Check or Cash

_____ Master/Visa Credit Card  Number

          _______________________________________

            Expiration Date ________________

 

I:

_____ am an MSPC Member

_____ was referred by  _____________________________________

_____ am a First Time Attendee

 

Menu:  Buffet Dinner, no selection is required.

 

 

 

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