2019 Dinner Registration Form

KMS members: please be sure to log in to your KMS account.

* Your Name

* Your Email Address

Seat Reservations:

♦ Adults: $250/person
♦ Students: $75/person
Please see additional options below for Journal Ad pricing and then reserve your seats

Enter your journal ad text here OR submit as an attachment below:

Attach Your Ad File Below

Your ad selection entitles you to up to 2 free seats.

How many of those seats will you be using?

If you need to purchase more seats, please make your selections below:

Number of Adult Seats ($250 each)

Number of Student Seats ($75 each)

Please enter the information for each Dinner guest below:

	* Name	* Title	Seating Requests

If you'd like to donate a different amount, please enter it here:

Total Amount Due

Thu, April 18 2019 13 Nisan 5779