MPFI Dinner Party Reservation Form

July 10th, 2007 Dinner Meeting
at
Sam Seltzer’s Steakhouse 4744 North Dale Mabry Highway in Tampa

Menu
Non Alcoholic Beverage
Garden Salad
Hard Rolls
Cheesecake w/Strawberry Sauce for Dessert
Name: __________________________________________
Company:_________________________________________

Phone Number: (___)_________________________________

E-Mail: __________________________________________

Units
Entrees
Amount Each
Amount Total
_____ Prime Rib (rare) (medium) (well) $20. members & 1 guest
$30. NonMembers
_____ Prime Rib (rare) (medium) (well) $20. members & 1 guest
$30. NonMembers
_____ Grouper (grilled) (fried) (blackened) $20. members & 1 guest
$30. NonMembers
_____ Grouper (grilled) (fried) (blackened) $20. members & 1 guest
$30. NonMembers
_____ Chicken Terriyaki $20. members & 1 guest
$30. NonMembers
_____ Fettucine and Vegetable Meal $20. members & 1 guest
$30. NonMembers
Members and Spouse ( or guest of member) $20 each - Non-Members $30 each

Please Print and fill this form out

Dinner Reservations and Checks Must be Received by Friday July 5th

Please make checks to Media Professionals of Florida, Inc.
and mail to:

MPFI Dinner
c/o Cathy Straka
1650 S. Hillcrest Avenue
Clearwater, FL 33756