REGISTRATION

Cocktail/Dinner Reception Registration Only

* First Name (Preferred name you wish to be called)

* Last Name

Address: Street City

State ZIP

* Your Email Address

* District Number

Rotary Club Name

Title (if applicable)( i.e. District Chair, Inbound Coordinator etc.)

Spouse/Significant Other Traveling With You

First Name Last Name

His/her Email Address

Rotary Club Name (if applicable)

Title ( i.e. District Chair, Inbound Coordinator etc.) (if applicable)

Hotel Reservations (if needed): The dinner registration does not include the hotel reservation as that must be done separately with the Marriott Chicago O’Hare for your room reservation. The room rate is $109.00 per night for a King Room and/or a room with Two Double Beds. (Hotel Rooms are available as early as Monday, February 22, 2010 thru Monday, March 1, 2010). The Hotel Room Rate of $109.00 is only guaranteed until Wednesday, February 3, 2010. After that the Marriott Chicago O’Hare Hotel doesn’t guarantee availability or rate. Please contact and/or click on the name link Marriott Chicago O’Hare Hotel for your room reservation.