Reservation Form - "Pink is Beautiful" Breast Cancer Awareness Luncheon & Fundraiser

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Tuesday, October 15, 2024

Island Way Grill - 20 Island Way, Clearwater

11:00 AM to 2:00 PM – Bar is Cash or Credit Card

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Single Reservation & Host Member

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Member ______________________________________________________(circle one below)

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     Petit Filet      Salmon      Chicken Piccata      Roasted Vegetables Stack        __GF   __Check   __Credit Card

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Table Reservations & Instructions

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To make your single reservation, request seats with friends or a full table of 8 or 10, the Host Member MUST complete this form. We will do our best to accommodate your request, but requests will be on a first come, first serve basis so the earlier you get your reservation in, the better we will be able to accommodate you.

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Please list the name of each person that is sitting at your table, their entrée choice and mark if they paid by check or online by credit card.

 

You. members & guests can pay by CHECK or CREDIT CARD.  ​You can include their checks for their lunch or they can mail their luncheon check separately to Reservations Chair Karin Stewart, 225 Windward Island, Clearwater, FL 33767.  Members & guests can also pay on line with their credit card. 

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         To pay by credit card use this link: 

 

Member/Guest 2  _______________________________________________ (circle one below)

  Petit Filet*       Salmon*      Chicken Piccata         Roasted Vegetables Stack    __GF  ___Check   ___Credit Card

Member/Guest 3  _______________________________________________ (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack   __GF   ___Check   ___Credit Card

Member/Guest 4   _______________________________________________ (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack   __GF   ___Check   ___Credit Card

Member/Guest 5  ________________________________________________ (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack   __GF   ___Check   ___Credit Card

Member/Guest 6   ________________________________________________ (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack   __GF   ___Check   ___Credit Card

 Member/Guest  7  _______________________________________________  (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack   __GF  ___Check   ___Credit Card

 Member/Guest  8  _______________________________________________  (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack  __GF   ___Check   ___Credit Card

Member/Guest  9  _______________________________________________  (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack  __GF   ___Check   ___Credit Card

  Member/Guest  10  _______________________________________________  (circle one below)

   Petit Filet*       Salmon*       Chicken Piccata         Roasted Vegetables Stack __GF   ___Check   ___Credit Card

 

Members--$35.00         Guests--$40.00        Number Attending ____ Total Enclosed $_____

​Phone Number:   ________________     eMail: ___________________________________

 

·        *GF - Gluten Free must be check on this if desired.  Filet or Salmon, only
 

​Instructions for Mailing in Reservation Form with your Check

Please make checks payable to: Island Estates Women’s Club and Send or Drop off  to: 

IEWC—c/o Karin Stewart, 225 Windward Island, Clearwater, FL or drop it off at her Home (White Mailbox)

• Important:  Reservation Deadline is Wednesday, October 9th at 12 Noon.  Payments must be in at the deadline.

• Money cannot be returned after the deadline as we are committed to the venue. 

• Questions:  Call Reservation Chair.  Karin Stewart at 727-452-5167

 

 

​To PRINT lunch reservation form - Control + P