60th “Diamond Jubilee” Annual Retirement and Recognition Dinner

MESSAGE TO ELIGIBLE RETIREES  :

If you want to attend the dinner, please email Kim Melfa @ [email protected]  and provide the following information.  Have your guests only use the registration form below to come in your honor.

• Your name
• Years of Service with BCPS
• Retirement Date
• Job title at retirement
• School/work location last worked
• Dietary restrictions/allergies
• Special needs

ALL OTHERS PLEASE USE THE REGISTRATION FORM BELOW TO REGISTER AND PAY FOR THOSE IN YOUR PARTY.

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MESSAGE FOR ELIGIBLE RETIREES-ONLY who want to attend the dinner

Please email Kim Melfa @ [email protected] if you wish to attend the dinner as our "guest." Please provide the following information 1-name 2-years of service with BCPS 3-job title at retirement 4-school/work location. Thankyou. The following registration form is for paying guests only. ELIGIBLE RETIREES DO NOT USE THE FORM TO REGISTER YOURSELF. Only use this form to register and pay for your guest.

Name *

First

Last

Email *

Email

Confirm Email

Phone *

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General Dinner Reservation $65/ea. *Select here1 Dinner Reservation - $65.002 Dinner Reservations - $130.003 Dinner Reservations - $195.004 Dinner Reservations - $260.005 Dinner Reservations - $325.006 Dinner Reservations - $390.007 Dinner Reservations - $455.008 Dinner Reservations - $520.009 Dinner Reservations - $585.0010 Dinner Reservations - $650.00

Select how many in your order here. Tables are set for 8 or 10.

Who are you or your group coming to celebrate? *

• BCPS Retiree
• Rookie Nominee/Award Recipient
• Recognition Nominee/Award Recipient
• Other

This question helps to group parties together. Choose "Other" to list the group/school you want to be seated with.

Enter the full name of the BCPS Retiree *

Enter the full name of the Rookie Nominee/Award Recipient? *

Enter the full name of the Recognition Nominee/Award Recipient? *

Other: What Group/School are you with? *

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Attendee Information

Provide all requested information for each person in your reservation. For BCPS employees, list the full school/office location (use these abbreviations: ES, MS, HS)

Attendee #1

Attendee #1

Enter requested information for each person in your party.

1 - FIRST NAME *

1 - LAST NAME *

1 - Are you a BCPS Employee? *

• Yes
• No

1 - What is your BCPS School/Office Location? *

1 - What is your job title? *

1 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #1 Special Needs

1 - Accessibility needs *

Wheelchair, walker, etc.

1 - Dietary restrictions *

1 - Any food allergies we need to inform the caterer about? *

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Attendee #2

Attendee #2

Enter requested information for each person in your party.

2 - FIRST NAME *

2 - LAST NAME *

2 - Are you a BCPS Employee? *

• Yes
• No

2 - What is your BCPS School/Office Location? *

2 - What is your job title? *

2 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #2 Special Needs

2 - Accessibility needs *

Wheelchair, walker, etc.

2 - Dietary restrictions *

2 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #3

Attendee #3

Enter requested information for each person in your party.

3 - FIRST NAME *

3 - LAST NAME *

3 - Are you a BCPS Employee? *

• Yes
• No

3 - What is your BCPS School/Office Location? *

3 - What is your job title? *

3 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #3 Special Needs

3 - Accessibility needs *

Wheelchair, walker, etc.

3 - Dietary restrictions *

3 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #4

Attendee #4

Enter requested information for each person in your party.

4 - FIRST NAME *

4 - LAST NAME *

4 - Are you a BCPS Employee? *

• Yes
• No

4 - What is your BCPS School/Office Location? *

4 - What is your job title? *

4 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #4 Special Needs

4 - Accessibility needs *

Wheelchair, walker, etc.

4 - Dietary restrictions *

4 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #5

Attendee #5

Enter requested information for each person in your party.

5 - FIRST NAME *

5 - LAST NAME *

5 - Are you a BCPS Employee? *

• Yes
• No

5 - What is your BCPS School/Office Location? *

5 - What is your job title? *

5 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #5 Special Needs

5 - Accessibility needs *

Wheelchair, walker, etc.

5 - Dietary restrictions *

5 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #6

Attendee #6

Enter requested information for each person in your party.

6 - FIRST NAME *

6 - LAST NAME *

6 - Are you a BCPS Employee? *

• Yes
• No

6 - What is your BCPS School/Office Location? *

6 - What is your job title? *

6 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #6 Special Needs

6 - Accessibility needs *

Wheelchair, walker, etc.

6 - Dietary restrictions *

6 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #7

Attendee #7

Enter requested information for each person in your party.

7 - FIRST NAME *

7 - LAST NAME *

7 - Are you a BCPS Employee? *

• Yes
• No

7 - What is your BCPS School/Office Location? *

7 - What is your job title? *

7 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #7 Special Needs

7 - Accessibility needs *

Wheelchair, walker, etc.

7 - Dietary restrictions *

7 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #8

Attendee #8

Enter requested information for each person in your party.

8 - FIRST NAME *

8 - LAST NAME *

8 - Are you a BCPS Employee? *

• Yes
• No

8 - What is your BCPS School/Office Location? *

8 - What is your job title? *

8 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #8 Special Needs

8 - Accessibility needs *

Wheelchair, walker, etc.

8 - Dietary restrictions *

8 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #9

Attendee #9

Enter requested information for each person in your party.

9 - FIRST NAME *

9 - LAST NAME *

9 - Are you a BCPS Employee? *

• Yes
• No

9 - What is your BCPS School/Office Location? *

9 - What is your job title? *

9 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #9 Special Needs

9 - Accessibility needs *

Wheelchair, walker, etc.

9 - Dietary restrictions *

9 - Any food allergies we need to inform the caterer about? *

Previous AttendeeNext

Attendee #10

Attendee #10

Enter requested information for each person in your party.

10 - FIRST NAME *

10 - LAST NAME *

10 - Are you a BCPS Employee? *

• Yes
• No

10 - What is your BCPS School/Office Location? *

10 - What is your job title? *

10 - Check off and provide any special needs you wish to share regarding accessibility, dietary restrictions or allergies, etc.) *

• Accessibility
• Dietary Restrictions
• Food Allergies
• None

Attendee #10 Special Needs

10 - Accessibility needs *

Wheelchair, walker, etc.

10 - Dietary restrictions *

10 - Any food allergies we need to inform the caterer about? *

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