Event Reservation - Lobster Bake

Event Reservation – Lobster Bake

When you reserve a seat for an event, you can pay by check or by credit card.

To pay by check, please download, complete and mail in the paper form and check by clicking on the button below.

To pay by credit card, complete the form on this page and pay online.

Name*
First Name Last Name
Firm
Phone
Fax
Email*
Are you a CIPLA member?*
- Yes
- No
Please reserve the following number of spaces for me at this CIPLA event.*
Additional Attendees
Please specify the name and membership status of each additional individual who will be attending this event.
Choice of Entrees
Please indicate the quantity for each entree requested.
Lobster
Lobster
Steak
Swordfish
BBQ Chicken and Smoked Sausage
Tenderloin
BBQ Chicken and Smoked Sausage
Chicken
Number of Attendees
Please indicate below the number of attendees in each membership category.
Member Registration Quantity
Price: $90.00
Non-Member Registration Quantity
Price: $90.00
Student Registration Quantity
Price: $70.00
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

Event Reservation – Lobster Bake