CICBVI Presents 10th Annual Community Banquet-- Participant Registration
Date: Friday, March 13th, 2020
Time: 6:00 p.m.
Location: Mt. Hawley Country Club (7724 N Knoxville Ave, Peoria, IL 61614)
Price: $100/ticket
Would you like to sponsor this event instead? Click the link below:
Registration Information:
Must be completed for EACH attendee to ensure accurate meal count.
Email Address: *
Your answer
Last Name *
Your answer
First Name *
Your answer
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Phone Number: *
Your answer
Meal Choice: *
Please list any dietary restrictions below (e.g. gluten-free, nut-free): *
Your answer
Comments (If registering a large group, please write seating preference here) :
Your answer
Payment Method: *
Please make check payable to "CICBVI" and send to:
Central Illinois Center for the Blind and Visually Impaired (CICBVI)
2905 W Garden St
Peoria, IL 61605

*Once payment is received, a receipt will be emailed to you or a printed receipt will be given to you the night of the event.
Paying using our PayPal account? Here's how:
*An online service fee of 3.00% will be added to your registration fee.
*A receipt will be emailed to you

1. Scroll down this page to "Online Payment" heading.
2. Select the number of tickets you would like to purchase from the drop down menu at the bottom of this page.
3. "Add to Cart" and pay using PayPal or your credit/debit card.
Questions?
Contact Felisa Durr
309-637-3693
info@cicbvi.org

OR

Darlene Violet
309-240-8597
groovym2@aol.com
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