1.First and Last(maiden) Name

*2.Which weekend in Sept or Oct would be better(Required.)

First weekend of either month

Second weekend of either month

Third weekend of either month

Last weekend of either month

Any

Other (please specify)

*3.How much would you be willing to spend per person to attend?(Required.)

$15

$30

$40

$50

*4.Would you be willing to donate time or money to assist?(Required.)

Yes

No

*5.Would you be willing to pay for your tickets now, so it would help secure the location, and help with food?(Required.)

Yes

No

*6.Do you know of any local small businesses or company’s that would be willing to promote and or donate money or services, such as facility rental, catering, sound/music etc.? If not, just answer N/A(Required.)