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CORPORATE PARTNER TABLE RESERVATION FORM

**RESERVATIONS DUE BY WEDNESDAY, DECEMBER 9, 2009**

As a benefit of your silver-level corporate partnership, you are entitled to 5 complimentary seats for the NAWBO-Indianapolis sixth annual awards and holiday luncheon, Celebrating Women presented by American Family Insurance.

Please complete the form below indicating your interest in using your seats and/or if you would like to purchase additional seats at the corporate partner rate of $60/per seat or if you would like to donate your seats back to NAWBO-Indy.

SUBMITTED BY
 NAME

 COMPANY

 ADDRESS

 DAYTIME PHONE NUMBER

 E-MAIL
(must be valid or your request will not be received)

PLEASE CHECK THE APPROPRIATE BOX (Select only one)

 Yes, we plan to use all 5 of our complimentary seats AND will supply the names and companies of our guests on or before Wednesday, Dec. 9, 2009.

 Yes, we plan to use all 5 of our complimentary seats AND would like to purchase  seats at the corporate partner rate of $60/per. In addition, I will supply the names and companies of our guests on or before Wednesday, Dec. 9, 2009. (more information will be provided upon clicking the Submit button below)

 No, we do not plan to use all 5 of our complimentary seats and would like to donate  seats back to NAWBO-Indianapolis to use for guest seating. In addition, if necessary, I will supply the names and companies of our guests on or before Wednesday, Dec. 9, 2009.

COMMENTS or NAMES OF ATTENDEES (PLEASE SEPARATE NAMES BY COMMAS)

Upon clicking Submit, you will be directed to a confirmation webpage that includes payment information. If are not directed to the confirmation webpage, your request was not received; therefore, please re-submit your request.

  

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