2015 CCSNMMI April Mixer

Stop by after work for a light snack, a beverage, lots of networking and a little about what the Central Chapter SNMMI is all about.

Question Title

* 1. Please tell us if you plan to attend the CCSNMMI Mixer on April 23rd:

Yes

No

Question Title

* 2. If you answered "yes" to the question above, please complete the information below:

Name: *

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Email Address: *

Question Title

* 3. Are you bringing a guest? If so, please complete the following information:

Name: *

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Country:

Email Address: *