Awards Banquet Table Reservation 2024

Thursday, May 2, 2024
Edward A. Dufresne Community Center
274 Judge Edward Dufresne Pkwy
Luling, LA 70070

5:30 – 6:30 PM Reception (Cash Bar)
6:30 – 8:30 PM Dinner and Awards Program

Contact Information
Your Name:
Your Email Address:
Your Phone Number: Your Phone Number: - ### - ### ####
Company Information
Company Name:
*exactly as you wish it to appear on all printed material
Company Address: Company Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Table/Seat Reservation

10 Seats Per Table
Table Reservation
Individual Seat Reservation
Guest Information

Please include the names of your guests in the spaces below:
Guest names must be emailed to kayla@mygcsc.com by April 25th to ensure a nametag.
Guest 1 Guest 1 First Last
Guest 2 Guest 2 First Last
Guest 3 Guest 3 First Last
Guest 4 Guest 4 First Last
Guest 5 Guest 5 First Last
Guest 6 Guest 6 First Last
Guest 7 Guest 7 First Last
Guest 8 Guest 8 First Last
Guest 9 Guest 9 First Last
Guest 10 Guest 10 First Last
Guest 11 Guest 11 First Last
Guest 12 Guest 12 First Last
Guest 13 Guest 13 First Last
Guest 14 Guest 14 First Last
Guest 15 Guest 15 First Last
Guest 16 Guest 16 First Last
Guest 17 Guest 17 First Last
Guest 18 Guest 18 First Last
Guest 19 Guest 19 First Last
Guest 20 Guest 20 First Last
Guest 21 Guest 21 First Last
Guest 22 Guest 22 First Last
Guest 23 Guest 23 First Last
Guest 24 Guest 24 First Last
Guest 25 Guest 25 First Last
Guest 26 Guest 26 First Last
Guest 27 Guest 27 First Last
Guest 28 Guest 28 First Last
Guest 29 Guest 29 First Last
Guest 30 Guest 30 First Last
Guest 31 Guest 31 First Last
Guest 32 Guest 32 First Last
Guest 33 Guest 33 First Last
Guest 34 Guest 34 First Last
Guest 35 Guest 35 First Last
Guest 36 Guest 36 First Last
Guest 37 Guest 37 First Last
Guest 38 Guest 38 First Last
Guest 39 Guest 39 First Last
Guest 40 Guest 40 First Last
Sponsorship
Please include our company as a sponsor for the following:

Sponsorship does not include table.

Deadline for submitting Ad information is March 28, 2024.
Please select your method of payment:
I would like to...

A convenience fee of 3% will be charged on all card payments.
PO #
Cardholder Name (as shown on card):
Card Type:
Other:
Card Number:
Security Code:
Expiration: Expiration: / MM / DD YYYY
Email Receipt to:
Billing Address

Billing Address Same as above
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Authorized Amount: $ Dollars . Cents
A convenience fee of 3% will be charged on all card payments.
I certify that I am the authorized holder and signer of the credit card referenced above. I certify that all information above is complete and accurate. I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the "Authorized Amount" field. If additional charges are going to be authorized a new form will have to be completed.
Authorization of Card Use

Authorization of Card Use I agree
Cardholder Signature:

Draw or Type

Clear

Full Name
Drink Tickets
Drink Tickets can be prepurchased or purchased at the event. Prepurchased Tickets will be redeemed after entry into the venue. Tickets are non-refundable.

1 Ticket = $1.00
I would like to prepurchase drink tickets.

I would like to prepurchase drink tickets. Yes No
Number of Drink Tickets:
If other, authorized amout: $ Dollars . Cents
Authorized person to receive tickets:
Please select your method of payment:
I would like to...

A convenience fee of 3% will be charged on all card payments.
PO #
Cardholder Name (as shown on card):
Card Type:
Other:
Card Number:
Security Code:
Expiration: Expiration: / MM / DD YYYY
Email Receipt to:
Billing Address

Billing Address Same as above
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Authorized Amount: $ Dollars . Cents
A convenience fee of 3% will be charged on all card payments.
I certify that I am the authorized holder and signer of the credit card referenced above. I certify that all information above is complete and accurate. I hereby authorize collection of payment for all charges as indicated above. Charges may not exceed the amount listed above in the "Authorized Amount" field. If additional charges are going to be authorized a new form will have to be completed.
Authorization of Card Use

Authorization of Card Use I agree
Cardholder Signature:

Draw or Type

Clear

Full Name
Terms and Conditions:

Terms and Conditions: I hereby understand that this registration is a binding agreement, and that once a reservation is submitted, it cannot be cancelled.
Confirmation:

Confirmation: I understand that I will receive a confirmation email upon submittal.

Awards Banquet Table Reservation 2024

Awards Banquet Table Reservation 2024

Contact Information

Company Information

Table/Seat Reservation

Guest Information

Sponsorship

Please select your method of payment:

Drink Tickets Drink Tickets can be prepurchased or purchased at the event. Prepurchased Tickets will be redeemed after entry into the venue. Tickets are non-refundable.

Please select your method of payment:

Drink Tickets
Drink Tickets can be prepurchased or purchased at the event. Prepurchased Tickets will be redeemed after entry into the venue. Tickets are non-refundable.