Gold Plate Dinner RSVP

Please complete this form and submit it by February 1, 2010. Please include the full name and business of your guests.

We will send an invoice for the number of tickets indicated to the address entered below. Questions? Please contact Michele Willard at 651-290-7848 or email mwillard@western-bank.com.

Each $125 ticket is for 2 people. Enter number of tickets you want to order.

First Name and Last Name

Your Business or Organization Name

Address 1

Address 2

City

State

ZipCode

Please enter a name and business for each guest. These entries will be used for name tags at the event. If you do not know the names of everyone in your party, please remit as unknown for now and we will contact you at a later date for more information.