Name: 2016 Annual Columbia Diversity Dinner
Start: 2016-10-06T17:30:00-06:00
End: 2016-10-06T20:30:00-06:00
Location: Courtyard Marriott

Name*

First Last

Company/Organization/School*

Address*

Street Address City State ZIP Code

Email*

Phone*

Are you a DAP Connect Member?*

Yes
No

Are you registering under a company's 2016 Diversity Dinner Sponsorship?*

Yes
No

If yes, which company?

General Dinner Ticket

Price: $50.00

Student Dinner Ticket

Price: $30.00

Table Sponsorship (Table of 8)

Price: $350.00

Please indicate any accommodations you require for this event:

Wheelchair Access
Sign Language Interpreter
Language Translator
Bringing Support Dog
Other (include in Questions/Comments section)

Dinner Selection*

Chicken – Boursin Chicken
Vegetarian – Vegetable Lasagna

Guest #1 Name

First Last

Guest #1 Email

Guest #1 Additional Accommodations

Wheelchair Access
Sign Language Interpreter
Language Translator
Bringing Support Dog
Other (include in Questions/Comments section)

Guest #1 Dinner Selection

Chicken – Boursin Chicken
Vegetarian – Vegetable Lasagna

Guest #2 Name

First Last

Guest #2 Email

Guest #2 Additional Accommodations

Wheelchair Access
Sign Language Interpreter
Language Translator
Bringing Support Dog
Other (include in Questions/Comments section)

Guest #2 Dinner Selection

Chicken – Boursin Chicken
Vegetarian – Vegetable Lasagna

Guest #3 Name

First Last

GUEST #3 Email

Guest #3 Additional Accommodations

Wheelchair Access
Sign Language Interpreter
Language Translator
Bringing Support Dog
Other (include in Questions/Comments section)

Guest #3 Dinner Selection

Chicken – Boursin Chicken
Vegetarian – Vegetable Lasagna

Total

$0.00

CANCELLATION POLICY
If you need to cancel your registration, 14 business days’ notice prior to the dinner is required for a refund of your registration cost. No refunds will be made after this date for any reason. Substitutions may be made at any time, without additional charges. Please contact Tina Mahtani at tmahtani@dapstl.org or 314-246-3146 with cancellations or questions.

Diversity Awareness Partnership

2016 Annual Columbia Diversity Dinner

October 6, 2016 @ 5:30 pm - 8:30 pm

2016 Diversity Dinner Registration Form (Columbia)

Details

Organizer

Venue