Dinner Reservations |

Dinner Reservations

Please fill out the form below and submit to begin reservation process. On the next page, complete the online payment process to reserve your seats at the awards dinner.

Reservation Form

Please complete all information:

Name *Your Name or Organization
Address *
Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone *
Number Attending *How many in your group?
Seating Preference *Who is the nominee you are honoring or what group do you want to be seated with?

Dinner Selections:

Rainbow Trout with hazelnut lemon butter, wild rice, steamed vegetables * Please place a zero for none.
Pesto Pasta Primavera - Vegetarian pasta *Please place a zero for none.
Cilantro Lime Chicken with rice and steamed vegetables *Please place a zero for none.

Verification

Please enter any two digits with no spaces (Example: 12)*

If you prefer to mail in your reservation, please click here for the printable form. Print and mail completed form to:

Nancy Rudisill
4427 Winding Circle
Colorado Springs, CO 80917
For more information, call:
719-380-1016 or 719-365-5996

Nursing History

Nursing Organization

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Dinner Reservations

Reservation Form

Please complete all information:

Dinner Selections:

Verification