Registration Form
Gold Circle Awards Dinner Meeting
October 22, 2020 | 5:00 pm - 8:00 pm
Casa Mia at the Hawthorne | Berlin, CT
CSA COVID-19 Safety Guidelines for October 22 Dinner Meeting
CSA's priority is our members’ health and safety so the set up for the CSA dinner will ensure that we follow social distancing guidelines. Masks will be required at registration and during the cocktail networking reception. Also the number that can sit at each table will be restricted to six people.
Company
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Address
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Phone
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City
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State
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Zip Code
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Name # 1
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Email # 1
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Name # 2
Email # 2
Name # 3
Email # 3
Name # 4
Email # 4
Name # 5
Email # 5
Name # 6
Email # 6
FEES
Member Dinner Fees = $75.00 for the first person; $65 for each additional attendee
Non-Member Dinner Fee = $110.00 per person
Member Sponsor Fee = $100.00; Non-Member Sponsor Fee - $300.00
Below, please check one box to calculate the cost for the attendee total.
Please also check the box to choose to be a sponsor.
# of Members
One
Two
Three
Four
Five
Six
# of Non Members
One
Two
Three
Four
Five
Six
Sponsor
Member
Non Member
TOTAL $
Payment Type
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Master Card
VISA
American Express
First Name
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Last Name
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Email
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Account #
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Security #
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Exp. Month
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Exp. Year
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Billing Zip Code
Yes,
I have read the CSA Safety Guidelines and agree to hold CSA harmless from any and all liability for unintentional exposure or harm due to COVID-19.
CSA | 1131-O Tolland Turnpike, # 272 | Manchester, CT 06042-1679 Phone: (866) 995-3919
www.connecticutsubcontractors.org
|
karen@connecticutsubcontractors.org
