Registration

Please join us on Friday, October 20th. The event begins with a buffet-style luncheon at 11:30 a.m. The program begins at noon. Cost is $15 per person. Please register by the end of day on Wednesday, October 18th. Thank you!

* = required field

Your browser is not running JavaScript or is too old to support our credit card payment process. Please reactivate JavaScript or try another browser. You will not be able to use this form.
Current Name:*
Class Year:
Graduation Name:
Preferred First Name:
Home Address:*
Home City:*
Home State:*
Home Phone/Cell Phone:
Employer/Occupation:
Work Phone:
Your Email:*
Please indicate any special meal preferences
Comments:
Spouse/Guest Information
Spouse/Guest Name:
Attended Luther?
Class Year or Years Attended:
Please indicate any special meal preferences
Comments:
Payment Amount*

Payment Information

Name as it appears on card*
Billing Street Address*
City*
State/Province*
Zip/Postal Code*
Country*
Tarbabypre
(Please don't fill in this field.)
Tarbaby
(Please don't fill in this field.)
Noturl
(Please don't fill in this field.)
Antlion
(Please don't fill in this field.)
  
Des Moines area Lunch Connection Event logo.