Reservation Form

 "Pink is Beautiful" Breast Cancer Awareness Luncheon & Fundraiser

Island Way Grill - 20 Island Way, Clearwater

Tuesday, October 18th, 2022—10:30 AM to 2:30 PM

Single Reservation

Member _____________________________________________________________________(circle one below)

                  Ranch Steak          Fresh Catch of the Day          Chicken Piccata          Shrimp Scampi

Table Reservation

      RESERVE TABLES FOR 8 FOR FUNDRAISER.  To reserve a table, you must complete this form. Please list the name of

       each person that is sitting at your table and their entrée choice.  You can attach their check for their lunch or they

       can mail lunch check separately to reservations chair Karin Stewart, address below.

 

Host Member  ______________________________________________________________________ (circle one below)

                  Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi    ___ Check    ___ Credit Card

Member/Guest 2  ________________________________________________________________(circle one below)

                  Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi    ___ Check    ___ Credit Card

Member/Guest 3  ________________________________________________________________ (circle one below)

                   Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi    ___ Check    ___ Credit Card

Member/Guest 4   ________________________________________________________________ (circle one below)

                   Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi   ___ Check    ___ Credit Card

Member/Guest 5  ________________________________________________________________ (circle one below)

                   Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi   ___ Check    ___ Credit Card

Member/Guest 6   ________________________________________________________________ (circle one below)

                   Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi    ___ Credit Card

Member/Guest  7  ________________________________________________________________ (circle one below)

               Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi    ___ Credit Card

Member/Guest   _________________________________________________________________ (circle one below)

                  Ranch Steak       Fresh Catch of the Day       Chicken Piccata      Shrimp Scampi   ___ Check    ___ Credit Card

 

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

Phone Number:   ________________     eMail: _____________________________________________

      Note:  We cannot refund money for cancelled reservations after the deadline because of our commitment to the venue providing

       our luncheon or program.

Instructions for Mailing in Reservation Form with your Check

Please make checks payable to: Island Estates Women’s Club Send to: 

IEWC—c/o Karin Stewart, 225 Windward Island, Clearwater, FL 33767 or you can easily drop it off at her address and place it in the IEWC White Mail Box. 

Important:  Reservation Deadline is Wednesday, October 12th at 12 Noon.

Or drop off at 31 Island Way, IEWC Drop Box before 5 pm. Closed Saturday and Sunday.

Reservations must be in the Drop Box by 12:00 Noon on the Deadline date.

To PRINT lunch reservation form and attached your check or checks - Control + P

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