RACC Event Registration Form

Name:
Email:
Are Are you a Chamber member?	Yes No
Company:
Address 1:
Address 2:
City, State Zip:
Phone:
Please comlpete the following for each event you wish to attend:
Annual Dinner - Friday, February 11 Cost: members-$25 non-members-$30 # of members attending # of non-members attending Name: Name:
Legislative Breakfast - Monday, February 14 Representatives Patsy French, Larry Townsend, and Senator Mark MacDonald, members-$12 non-members-$14 Cost - members-$12 non-members-$14 # of members attending # of non-members attending Name: Name:
Legislative Breakfast - Monday, March 21 Lt. Governor Phil Scott Cost: members-$12 non-members-$14 # of members attending # of non-members attending Name: Name:
Legislative Breakfast - Monday, April 11, 2011 Governor Peter Shumlin Cost: members-$12 non-members-$14 Number of members attending Number of non-members attending Name: Name:
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