2022 Annual Dinner Registration Form Annual Dinner 2022 Annual Dinner 2022 Name * First Last * Last Address Address Address Line 1 Address Line 1 Address Line 2 Address Line 2 City City State Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State Zip Code Zip Code Phone Number * Email * We are delighted that you will be joining us for our 2022 Annual Dinner to celebrate ECOS’s 50th Anniversary. Each dinner is $100.00. Entree choices include: Harvest stuffed chicken breast – breast of chicken filled with cranberry & apple pear stuffing, served with a Grand Marnier cranberry glaze Salmon – soy sauce & ginger Stuffed peppers – red and yellow bell peppers filled with Israeli vegetable couscous; roasted red pepper sauce Number of Dinners * Entrée Choice * Stuffed chicken breast Salmon with soy sauce & ginger Stuffed bell peppers Additional diner – Entrée Choice Stuffed chicken breast Salmon with soy sauce & ginger Stuffed bell peppers Total Payment Each dinner is $100.00 each If you are human, leave this field blank. Submit
