Kitimat CDC Satisfaction Survey Form

1

Name* This field is required.

First Name

Last Name

2

Company Name* This field is required.

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Email* This field is required.

example@example.com

5

Registering for:* This field is required.

Golf & Banquet($100)

Banquet only($40)

6

How many golfers would you like to register?* This field is required.

1

2

3

4

7

Golfer 1 Name* This field is required.

8

Golfer 2 Name

9

Golfer 3 Name

10

Golfer 4 Name

11

Would you also like to sponsor this year's Golf tournament?* This field is required.

YESNO

12

How many banquet tickets would you like to purchase ($40/each). Please only include non-golfers in this section!* This field is required.

0

1

2

3

4

13

Banquet Guest 1 Name* This field is required.

14

Banquet Guest 2 Name

15

Banquet Guest 3 Name

16

Banquet Guest 4 Name

18

Are there any dietary restrictions/allergies that we should be aware of?

19

Total in CAD(Does not include sponsorship selections)

20

What is your preferred payment method?* This field is required.

Cheque (Mail or In-Person at 1515 Kingfisher Ave, Kitimat, BC)

Credit or Debit (In-Person at 1515 Kingfisher Ave, Kitimat, BC)

Pre-Authorized Credit Card Transaction (We'll email you a form!)

21

Click here to download the form and email to events@kitimatcdc.ca

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Any additional comments