The document is a response form for the MOESGR Annual Awards Dinner to be held on August 24, 2012 at the Capitol Plaza Hotel Ballroom in Jefferson City, Missouri from 6:00 PM to 10:00 PM. It provides information on attending the cocktail reception and dinner program, includes spaces to print the name of the company/organization and guests attending, any dietary restrictions, and includes details on costs and payment if guests beyond the primary attendee will be coming. It also provides contact information if reservations need to be changed or canceled.

1. RESPONSE FORM
MOESGR Annual Awards Dinner
August 24, 2012
6:00 p.m. for Cocktail Reception
7 p.m. – 10:00 p.m. for Dinner Program
Capitol Plaza Hotel Ballroom
415 W. McCarty Street
Jefferson City, MO 65101
Company/Organization Name: _______________________________________________________________
(Please Print)
Address: _____________________________________________________________________________
(City, State, Zip)
______ I/we will attend the evening Reception and Dinner.
____________________________________________________________________________
____________________________________________________________________________
(Please Print and Provide all names of guests and indicate any dietary restrictions above)
______ No, I/we will be unable to attend the Reception and Dinner.
Dinner cost to you and your spouse/guest will be borne by the MOESGR Association.
Costs for additional guests, $45.00, will be the responsibility of the company or individual.
Enclosed is a check payable to “Missouri ESGR Association” for _________ guests at $45 per person
for the dinner.
Return this form (with check, if appropriate) to ESGR, Attn: Steve Brothers, Ike Skelton Training Site
(ISTS), Jefferson City, MO, 65101, NO LATER THAN… Wednesday, August 15, 2010.
If your plans change and you need to change or cancel your reservation, please advise
Steve Brothers at 573-638-9500 ext. 7730.