January 10, 2018 Member- Guest Dinner & Professional Development Registration Form
You will be able to make modifications after completion of form. If you need to make changes after that, please contact Kay LaDuke at
. *** REGISTRATION CLOSES Thursday January 4, 2018 at 6 pm ***
The Skyline Club in Southfield
If you are registering others and you have previously completed your registration, you do not need to register again - just enter the information for those who have not registered.
Are you a Member or Guest
I am an EWI Member Firm or Representative
I am not an EWI Representative but I am an employee of an EWI Member Firm
I am a Guest*
*If you're a guest, how did you hear about this dinner?
Business or Firm Name (enter NA if none)
Attendee #1 (you'll enter others you are registering for later)
Herb Roasted Chicken
Quinoa Cake- Red and Black Quinoa, sweet potato with a tomato sauce
Special Dietary Request Needed (email Kay LaDuke at
I understand my registration is NOT CONFIRMED until I complete payment. Click on SUBMIT below. *
Contact Kay at
if you request other payment arrangements.
Yes, I understand and am paying by credit card or Paypal ONLINE (continue and Submit form to get Paypal link).
Are you registering for others besides yourself? *
Yes, I need to register others with my registration
No, I'm registering for just me.
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