TOTAL Roasted Chicken _______ TOTAL Lasagne _______ TOTAL Atlantic Salmon _______

2016 APWA Holiday Luncheon TABLE RESERVATION FORM Use this form only AFTER you have registered and provided payment for your Table of 8 by registering at http://northernca.apwa.net

PLEASE TYPE ONLY!

$40.00 per person ($280 table of 8) if paid by November 27, 2016

$50.00 for individual attendee registration if paid by December 9,2016

Walk-ins (if space allows): $60.00 per person

Agency/Company:____________________________________________ E-Mail: ________________________________

Contact Person: ______________________________________________ Phone: ____________________________________

Address: ____________________________________________________ Tables: _______x $280.00 $ ________

TOTAL ENCLOSED =

2016 APWA Holiday Luncheon

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables

NAME: _________________________

Herb Roasted Chicken: Atlantic Salmon Filet:

Lasagne Prepared with Roasted Vegetables