*1.Contact Information:(Required.)

First *

Last *

Company

City/Town *

State *

Email Address *

*2.Please check the Lunch and Learn that you will attend. All begin at 12 noon.(Required.)

Oct 18 - Ankeny - Kirkendall Public Library, Room BC, 1250 SW District Drive

Oct 20 - Cedar Rapids - City Services Center, Time Check Hall, 500 15th Avenue SW

Oct 27 - Sioux City - City Hall, Lower Level Conference Room, 405 6th Street

Nov 1 - Council Bluffs - Public Library, Room A, 400 Willow Avenue

Nov 3 - Waterloo - Hawkeye Community College, Buchanan Hall Room 104

Nov 17 - Iowa City - City Hall, Emma J. Harvat Hall, 410 E Washington Street

*3.Order a $5 box lunch for me. (Please bring cash or a check made out to Iowa State University.) Note these deadlines for box lunch orders:

Ankeny - Oct 13	Cedar Rapids - Oct 14	Sioux City - Oct 21
Council Bluffs - Oct 26	Waterloo - Oct 28	Iowa City - Nov 11

(Required.)

Yes

No

4.Special diet consideration?

None

Gluten Free

Vegetarian

Other (please specify)