The Children's Book Guild of Washington D.C.
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Event Form
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Children's Book Award Luncheon
Saturday, Nov 4, 2006

If paying with credit card, please give name, as it appears on the card and use billing address.
Please make checks payable to: The Children's Book Guild
* = Required Information

PLEASE FILL OUT ALL REQUIRED FIELDS (indicated by *)
*Name:
*Organization:
*Address:
*City:
*State:
*Zip/Post Code:
Country:
*Phone Number:
*E-Mail Address:
*No. of Tickets
*Amount
($55 each)
(If mailing, please enclose)

*Credit Card Information
*Credit Card Type: Visa MasterCard American Express
*Card Number:
*Expiration Date:
(mm/yy)
 
___________________________________
Signature (If Faxing or Mailing)
If you wish to fax or mail this form, please fill out this form, and print and fax/mail to:
The Children's Book Guild
7513 Shadywood Rd.
Bethesda, MD 20817
OR Fax to: (301) 469-2071

Enclose: a stamped, self addressed envelope and this registration form.
Tickets: will be mailed one week before the event and are not refundable.
Group Seating: requests must be mailed together. Tables seat 10. Tickets will be mailed to one address.
Seating: will be by order of receipt of reservations.
Library Book Buyers: are reminded to bring tax exempt numbers.
For More Information:
phone: (301) 469-2070 fax: (301) 469-2071 or e-mail: marilyn@childrenslit.com