Toledo Section Meeting Reservation Form

	Institute Night 2009 -- On-Line Reservation Form

Please provide all information requested below in order to reserve a seat for the IEEE Toledo Section meeting on November 12, 2009 no later than the registration deadline - 5:00 PM, Friday, November 6th. Please submit a separate form for each person in your party.

We are commited to pay for the number of meals reserved, so please cancel if you must by the registration deadline. If paying by check please make payable to Toledo Section, IEEE.

Dinner prices, $20 (IEEE Student Members $10.00), and non-members $30.00 (with a 50% refund for them and their guests if they join IEEE by 12/31/2009).

The menu is a dinner buffet featuring Chicken Marsala, Vegetable Lasagna, Herb Roasted Red Skin Potatoes, Wild Rice, and Betty's Salad and will include dessert and coffee or tea. A cash bar will be available throughout the evening.

**Meeting Registration Entry Form**
**Fields labeled in red are required**
First Name:	Last Name:
Organization Membership:
Bus. Tel. No.:	Home Tel. No.:
E-Mail Address:
Company Affiliation:
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	Enter the Following ID Code:
Click here to complete reservation