LIRW Members: $40/ non-LIRW: $50

***PLEASE NOTE: Attendees paying the LIRW Member rate must be members
in good standing PRIOR to March 31, 2008.***

You Must be an RWA member to attend this event.
Please see the RWA website for information on joining.

Name:___________________________________________

Address:__________________________________________

_________________________________________________

Phone: (____)______________________________________

E-Mail:___________________________________________

Special Dietary Request:_____________________________________
Please note, LIRW will do their best to accomodate this request but can make No Guarantee

Name as you would like it to appear on your Luncheon Name Badge
(4 line Maximum, 3 is bigger and better!)

1._______________________________________________

2._______________________________________________

3._______________________________________________

4._______________________________________________
The LIRW suggests something along the lines of:

Wanda Wonderful writing as SALLY SUPERSTAR LIRW, FF&P, KOD

Make check payable to LIRW and send with this form to:
Deborah Rabbitt, Chairperson
1 Antrim Lane
Farmingville, NY 11738

e-mail: luncheon@lirw.org
for more information
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