2019 On-Line Banquet Reservation Form For TABLE of 8 Seats

First Name*

Last Name*

Phone*

Email*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Number of people in my party-including myself*

8

Additional Guests: Fill in selections for all 8 seats.

Person #2 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #3 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #4 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #5 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #6 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #7 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Person #8 First Name*

Last Name*

Dinner Choice (Choose ONE)*

Grilled Chicken Bruschetta
Sliced London Broil
Citrus-Basil Tilapia

Any additional Comments, Questions or Concerns

Tickets*

Price: $290.00 Quantity:

For Quantity, please enter the number 1 for 1 table of 8 seats.

Total

$0.00

Payment will be made by*

PayPal (You do not need to be a PayPal member)
Check or Cash

Please prove that you are human by checking the box: *

Additional Guests: Fill in selections for all 8 seats.

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