2019-20 Arizona Optimist District Conference Registration Form
4th Quarter
Email address *
Full Name *
Phone # *
Club Name *
Is this your first Arizona District Conference? *
How many Member registrations - ($10)? *
Additional Member names
How many Guest Registrations ($5)? *
Guest names
How many will attend the PGA Dinner (by invitation only)?
How many Grilled Chicken salad lunches ($24)?
How many Penne Pasta lunches ($24)?
How many Bistro Steak (similar to sirloin) dinners ($36)?
How many Italian Chicken dinners ($36)?
Do you plan to participate in Envy Escape Room ($5)? *
How many Sunday breakfasts ($20)?
Notes/Special Needs
A copy of your responses will be emailed to the address you provided.
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