Nov-Dec 2009 Klaxon - Midwestern Council of Sports Car Clubs

Banquet ReservationJanuary 16 th , 2010Please select your dinner preferences from the following delicious entrees:Stuffed Pork Loin ~ Stuffed with Prosciutto Ham, Shrimp & White Wine, Baked withParmesan CheeseApple Almond Stuffed Chicken ~ Boneless Chicken Breast stuffed with Apple AlmondBread Dressing finished with White Wine Cream SauceHerb Crusted Tilapia ~ Crusted with Herbs and Seasoned Breadcrumbs finished withWhite Wine SauceIf a Vegetarian or Child option is preferred, please make a request to the Registrar.Guest NameDinner Selection____________________________ □ Pork □ Chicken □ Fish____________________________ □ Pork □ Chicken □ Fish____________________________ □ Pork □ Chicken □ Fish____________________________ □ Pork □ Chicken □ FishTotal Cost of Reservations$40 X ______________ = ___________# of GuestsLess Free Class Champion - ___________(please indicate class)Less Worker Credits @ $2 per credit - ___________(worker log book must accompanyreservation, unused credits will be returned)Total Amount Sent(Make checks payable to MCSCC)$__________Email Address or Phone # if Registrar has questions: _________________________(Please make copies of the form for additional guests if necessary)Banquet Reservations & payment must be received not later than Saturday, December 26, 2009