2nd Annual Women of Distinction Awards Luncheon Registration Form
Join Assemblywoman Michaelle C. Solages in celebrating remarkable women and their efforts to improve our community.  Each guest is required to complete the registration form. If you have questions regarding the registration process or if you would like  to register as a group, please contact our office: 516-599-2972 or ms@michaellesolages.com.  
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NAME *
ZIP CODE *
PHONE NUMBER *
 Phone number should be 10 digits, excluding parentheses and dashes. Example: 1231231234
EMAIL *
NAME OF GUEST
Register one attendee and guest per form
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