10th Annual Women in Business Celebrate Success! Gala Luncheon - Registration Form

Friday, October 19, 2006

Pooks Hill Marriott

Business Showcase & Marketplace opens 10:00 a.m. to 3 p.m.
Lunch and Program Noon to 2:00 p.m.

Featuring Susan Lacz, Ridgewells

Presented by: Women Business Owners of Montgomery County

Partners:
Rockville Economic Development, Inc.
Rockville Chamber of Commerce
Montgomery County Department of Economic Development
Montgomery County Chamber of Commercd


To ensure you are properly recognized in the program, please fill in this form completely and legibly. The information provided will be used for your name badge and program description. Attach extra sheets if registering for more than one person.

Name(s): _________________________________________________________

Organization:______________________________________________________

Address: _________________________________________________________

City, State, Zip: ____________________________________________________

Phone: ____________________________

Fax: ______________________________

Email: _____________________________

Luncheon Choice:   Chicken ____         Vegetarian ____

____ WBO Members August Special until August 30th:  $50        

____ Advance registration until September 30:   $55
         
(Non-member rate or member rate from August 31st – September 30th)
         [must be postmarked by September 30 to guarantee listing in the program]

____ From October 1st to October 13th:   $65

____ At door:  $75

____ No. of Reservations

____ Table for Ten:  $550

Check enclosed (payable to WBO) $ ___________

Credit Card (Visa, MC) $_____________________

Account Number: ____________________________________________________

Exp. Date__________________________________________________________

Name of Cardholder (print):

__________________________________________________________________

Signature of Cardholder:

__________________________________________________________________

[ ] Please check here if you would like to receive a WBO-MC membership application.

To advertise, exhibit, sponsor, or obtain more information call 877-461-9901 (Gala Chair), visit www.wbo-mc.com/gala or e-mail wbo@wbo-mc.com

Fax completed form with credit card payment to Chiquita Sorrels, 301-871-3660 or mail with check to WBO Gala, PO Box 1281, Rockville, MD  20849-1281.

Women Business Owners of Montgomery County is recognized by the IRS as a Section 501(c)(6) non-profit organization covering business leagues. Contributions or gifts to WBO-MC are not tax deductible as charitable contributions. However, they may be tax deductible as ordinary and necessary business expenses.
Women Business Owners of Montgomery County – Federal ID# 52-1741287