Engineer's Week Banquet -- On-Line Reservation Form

Please provide all information requested below in order to reserve a seat for the IEEE Engineer's Week Banquet table on February 18, 2010 no later than the registration deadline - 5:00 PM, Monday, February 8, 2010.

We are committed 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.

IEEE Member Banquet Dinner: $15
IEEE Student Members: $10


Banquet 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:
Click here to clear the form
Enter the Following ID Code:[ Random Image ]
Click here to complete reservation