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February 5, 2013

Event Registration

Register here for the Disruptive Diner. When you've finished this short form, you'll be able to confirm your entries and then you'll be taken to PayPal for payment.

  (including yourself)
Fill in your registration information on this page. If you are registering additional people, you will be able to enter their registration information after you complete this page and click "Continue".
Event Fee(s)
Please select from below:
Select your registration type. Next you'll select the type of lunch you'd like.
Disruptive Diner events feature delicious fresh wraps and salads from Green Bean (www.greenbeansalads.com). Select your ingredients and next you'll select whether you'd like your order as a wrap or a salad.
Select whether you'd like your ingredients as a salad or wrap. Next, you'll choose a beverage (included with lunch).

A drink is included with your lunch. If you are not purchasing lunch, select "none."
Thanks for being part of the Disruptive Diner.
If you would like to create an account on this site, check the box below and enter a user name If you already have an account, please login before completing this form.
Disruptive Diner Participant Profile

Please tell us a little about yourself.

 
  Do you have any special dietary requirements?
       

Thanks for your help. We look forward to seeing you at the Disruptive Diner.

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This entry was posted on February 5, 2013 at 9:50 am and is filed under . You can follow any responses to this entry through the RSS 2.0 feed.

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