_______________________________________ Your Kingsport Chamber 70th Annual Dinner Reply Form To RSVP, please send completed form and payment to: PHONE: 423.392.8832 FAX: 423.392.8834 E-MAIL: [email protected]. MAIL: Kingsport Chamber 400 Clinchfield Street, Suite 100 | Kingsport, TN 37660
Checks preferred. Please make payable to Kingsport Chamber. Company: __________________________________________________________ Address: ___________________________________________________________ City: ___________________________ State: ________ Zip: _________________ Contact: ________________________________ Phone: _____________________ E-mail: ____________________________________________________________
Number Attending: ________
Name(s) of those attending: ____________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ______________________________________________________________________________________
Credit Card (check one): ______ Visa _____ Master Card
Total Amount: $______________
Card #: _______________________________________
Exp. Date: ____________
Three-Digit Code: __________
Billing Zip Code: _______________
Signature: _____________________________________
Please reserve _____ vegetarian dinners for (
please provide names):
___________________
___________________
___________________
Tickets are $120 per person.
No refunds after Friday, January 20, 2017.
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