For purposes of notifying the restaurant, we must have all registrations
by 2 p.m. on the Monday before the PDM.
  Any registrations after that time will be accepted, but the meal of choice
can NOT be guaranteed.

Please fill out the data below and then submit the form to register for this months Professional Development Meeting or call Tim Mackin @ 860-678-6578

First Name:

Last Name:

Email Address:

Company Name:

Membership Status:
Member:
Non Member:
Student:
Retired:
Unemployed:

Pricing:
$25 Members/Non-Members
$10 Retired/Unemployed
No Charge - Student Chapter Members Only

Select meal choice:  
Buffet Vegetarian Alternate

Meetings begin with drinks and socializing. Dinner will be a buffet. Dinner finishes with a dessert. Beverages include coffee and tea.

Phone Number (e.g. 800-123-4567)
(to call in the event of a cancellation):

Number attending (if more than one):

Comments / suggestions or thoughts about our meetings are welcome too:

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If it is complete the click the submit button: or clear