48th Annual National Engineers Week Banquet
Friday- February 19, 2010
Arsenal Club / Heritage Hall • Bldg 60 • 1 Rock Island Arsenal • Rock Island, Illinois
5:00 - 6:25 PM Social with cash bar, complimentary Hors d’oeuvres, silent auction, and displays
6:25 - 7:30 PM Dinner
7:30 - 9:00 PM Program and Awards

On-line Registration Form
 

First Name: Last Name:   Cost:
E-mail Address:       Daytime Phone (w/ Area Code):
Primary Society Membership:
Company/Employer or School (if full time Student): 
Job Title:
Address 1:
Address 2:
City:  
State:   Zipcode:
Additional Guest Registrants:
First Name: Last Name: Banquet Cost:
 
Comments/Special Instructions: 
QCESC $$$ Donation:       Amount:   
Note:  Donations are tax deductable and will be used to fund QCESC Programs including scholarships and awards.

Notes:

  1. Payment for the banquet by check should be mailed and received by February 12, 2010 at:
    QCESC
    PO Box 1526
    Moline, IL 61266

    Costs are as follows:  $35/person except for full time students with an ID who are $20/person.
     

  2. A confirmation of the information you submitted will be displayed on your web browser after you submit your registration.  If you there are any errors or changes after you submit the registration, resubmit the registration.  An e-mail confirmation will be sent back to you within 2 days.
     

  3. If have any problems or need further assistance in registering, Contact Pat Barnes via e-mail at banquet@qcesc.org or call 309-765-3629
     

  4. The name and society information you submit will be used to create your name tag for the banquet
     

  5. The information you provided will only be used by QCESC and won't be redistributed or sold.

    

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