46th Annual National Engineers Week Banquet
Thursday- February 21, 2008
Putnam Museum  • I1717 West 12th Street  • Davenport, Iowa
6:00 - 7:00 PM Social - 7:00 - 8:00 PM Dinner - 8:00 - 9:00 PM Program and Awards
5:30 - 7:00 PM - Optional Da Vinci Exhibition

On-line Registration Form
 

First Name: Last Name:   Cost: (see note 1)
E-mail Address:       Daytime Phone (w/ Area Code):
Plan to Attend Da Vinci Exhibit:
Primary Society Membership:
Company/Employer or School (if full time Student): 
Job Title:
Address 1:
Address 2:
City:  
State:   Zip:
Additional Guest Registrants:
First Name: Last Name: Cost: Plan to Attend Da Vinci Exhibit:
     
Special Instructions:
QCESC $$$ Donation:       Amount:   
Note:  Donations will be used to fund QCESC Programs including scholarships and awards.

Notes:

Payment for the banquet by check should be mailed by February 16, 2008 to:
QCESC
PO Box 1526
Moline, IL 61266

Costs are as follows:  $35/person except for full time students which are $20/person.
 
The payment for the optional, Leonardo Da Vinci Exhibition shall be made when you arrive at the Putnam on February 21 (no advance payment is necessary).  The Da Vinci Exhibition will be open to the banquet attendees only from 5:30 - 7:00 PM with the following special pricing:
-  $7 Adults (normally $12)
-  $5 Full Time Students (normally $10)
 
For the banquet food, if a vegetarian alternative is required or if you have any other special needs, please indicate this when registering in the "Comments/Special Instructions" field.
 
A confirmation of the information you submitted will be displayed on your web browser after you submit your registration.  If you there are any errors or changes after you submit the registration, resubmit the registration.
 
If have any problems or need further assistance in registering, either send an e-mail to presidnet@qcesc.org or call the QCESC President, Pat Barnes @ 309-765-5556
 
The name and society information you submit will be used to create your name tag for the banquet
 
The information you provided will only be used by QCESC and won't be redistributed or sold.

    

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