Reservations Form
The Democratic Club of Worcester County, the Democratic Women's Club, and the Democratic Club of Ocean City/Berlin Present
The 14th Annual Kennedy - King Dinner APRIL 16, 2016- THE ATLANTIC HOTEL, BERLIN, MD
In Support of The Democratic Central Committee of Worcester County SPECIAL GUEST – JIM IRETON CANDIDATE FOR MARYLAND CONGRESSIONAL DISTRICT 1
KEYNOTE SPEAKER – FRED MASON
PRESIDENT OF THE MARYLAND STATE AND DISTRICT OF COLUMBIA, AFL-CIO
Tickets for the Dinner are $100 contribution per person. The price for participants in the Blue Campaign is $75 per person. Please fill out the information below and return this form to the address at the bottom of this form. Hosted Reception 6pm; Call to Dinner 7pm
------------------------------------------------------------------Please reserve ____ for the dinner. Total for Dinner Reservation: $100 x_________ = $ _______________ Blue Campaign participant ☐ dinner: $75 x _________ = $________________ Additional contribution to support programs of the DCCWC $___________________ Total Contribution (Dinner & More) $ ________________ Name(s) on the reservation: _______________________________________________________ ________________________________________________________________________________ Address to receive Confirmation your tickets: ________________________________________ ________________________________________________________________________________ Contributor Occupation* _______________________ Employers Name ____________________ *If retired, please enter “Retired” *Contributor Info is required by Maryland law. Your Telephone # ______________________ and email Address __________________________ Please select your entrees: Entrée Selections: ☐ Sliced tenderloin w/demi-glace/crispy onions ☐ Crab Cakes a la MD ☐ Chicken Breast Marsala ☐ Vegetable Pasta with Portabella in Cream Sauce EARLY BIRD RATE THROUGH MARCH 15, 2016 IS $75 PER PERSON. -----------------------------------------------------------------------------------------------☐ Pay by Check: Please make your check payable to DCCWC and mail to: Lanny Hickman PO Box 1422 Ocean Pines, MD 21811 Questions? Call Lanny @ 410-600-0552 Reservations by Phone: C all Lanny @ 410-600-0552 Or by email: s
[email protected] Authorized by the DCCWC, Lanny Hickman, Treasurer, All funds solicited in connection with this event are by the DCCWC and not on behalf of congressional candidate Jim Ireton or by any other political candidate.
