Lantern Gala Table Registration - Lee Carlson Center for Mental Health and Well-Being

Tables may include up to 8 guests.

Name of Head of Table

Street Address

City

State

Zip Code

Phone Number

Email Address

Payment

Number of Guests Attending (not including head of table)

Guest One Name

Vegetarian Option

Yes

Guest Two Name

Vegetarian Option

Yes

Guest Three Name

Vegetarian Option

Yes

Guest Four Name

Vegetarian Option

Yes

Guest Five Name

Vegetarian Option

Yes

Guest Six Name

Vegetarian Option

Yes

Guest Seven Name

Vegetarian Option

Yes

Comments (i.e. food allergies or questions)

If you chose to mail a check, please mail to:

Rob Edwards
Lee Carlson Center
7954 University Avenue NE
Fridley, MN 55432

Or pledge your support to Patty at 763.230.7836 or phalvorson@leecarlsoncenter.org and pay the entry fee later.