Friday Banquet Preference:  (check one)

Vegetarian         Yes             No

 

Vendor Name: _________________________________________________________
Vendor Representative: ___________________________________________________
Vendor Address: _______________________________________________________
City: ___________________________	State: ________________	ZIP: ______________
Email:___________________________	Phone: _______________	FAX: _____________

Please write checks or money orders to Loyola College.  Loyola College does not accept credit cards.

Loyola College will assess a charge of $25 for each check returned.

Please mail this form to the following:

Dr. Dawn Lawrie Department of Computer Science Loyola College in Maryland 4501 North Charles Street Baltimore, Maryland 21210 Tel : (410) 617-2140 Fax: (410) 617-2157 Email: dlawrie@loyola.edu

For more information, please see: http://justice.loyola.edu/ccsce04 and/or http://www.ccsc.org/

Regions are: Central Plains, Eastern, Midwest, Northeast, Northwest, Rocky Mountain, South Central, Southeast.
 

* Registration covers meals for two individuals. Additional meals can be purchased.