Restaurant Name ______________________________________

Samples to be Served ______________________________________

______________________________________

Contact Person (Name) ______________________________________

Telephone( )______________________Cell( )_____________________

Email:_____________________________________________________________

Web Address:_______________________________________________________

Please List Participating Staff Members’ Names

______________________________________

______________________________________

______________________________________

I will need the following:

Serving Assistance____________________________________________________

Pre-Event Set up_____________________________________________________

Electrical (limited) ______________Ice (Quantity)___________________________

Other ______________________________________________________________