Fall Conference Convention 2024 Application

Fall Conference Convention 2024 Application

November 8 - November 10, 2024 - Ocean Place Resort & Spa, Long Branch, NJ
Name*

First NameLast Name
Title*

Exalted RulerVice PresidentDistrict DeputyState TrusteePast State PresidentOther
Please select your Elks Lodge*
Please select your District*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*

Confirmation Emailconfirm email
Phone Number*
Please enter a valid phone number.
Number of persons in room:*

0 No Room Needed - Not Staying1234
What package are you selecting?*

2 Night Package #1 (1 Person) Friday, November 8 - Sunday, November 10 @ $559 Check $579 Credit Card2 Night Package #2 (2 Person) Friday, November 8 - Sunday, November 10 @ $771 Check $798 Credit Card
A = Amount of your package*
If staying MORE than 2 nights, which night(s) are you ADDING to your package?*

Not adding extra night(s) - $0Wednesday, November 6, 2024 @ $171 Check $177 Credit CardThursday, November 7, 2024 @ $171 Check $177 Credit Card
B = Amount of extra charges:*
A + B = Total amount of package and extra charges:*
Prefer room with:*

1 Bed2 BedsNo Preference
Handicapped/Wheelchair Accessible*

NoYes
If yes, what special needs do you require (room close to elevator, wheelchair accessible, other, please describe):
Your package includes: Two nights lodging (Friday and Saturday), taxes, fees, parking, Friday Picnic Party, Saturday Luncheon, and Saturday Banquet (make choices below).
Choice of Entree for Saturday's State Banquet - Person #1*

Stuffed Chicken Breast with Proscuitto and Sun Dried Tomatoes (GF)Braised Short Rib with a Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato Sauce
Choice of Entree for Saturday's State Banquet - Person #2*

Stuffed Chicken Breast with Proscuitto and Sun Dried Tomatoes (GF)Braised Short Rib with Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato SauceNot applicable
Choice of Entree for Saturday's State Banquet - Person #3*

Stuffed Chicken Breast with Proscuitto and Sun dried Tomatoes (GF)Braised Short Rib with Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato SauceNot applicable
Event Only Options - Complete only if you are NOT making room reservations and are planning to attend any function listed below.
Friday Picnic Party @ $82 Check per person $85 Credit Card per person*

1 Person2 Persons ($164 Check, $170 Credit Card)3 Persons ($246 Check, $255 Credit Card)4 Persons ($328 Check, $340 Credit Card)Not Applicable
C = Amount of Friday Picnic Party*
Saturday Luncheon @$35 Check per person $37 Credit Card per person*

1 Person2 Persons ($70 Check, $74 Credit Card)3 Persons ($105 Check, $111 Credit Card)4 Persons ($140 Check, $148 Credit Card)Not Applicable
D = Amount of Saturday Luncheon*
Choice of Entree - Saturday Banquet - Person #1 @ $100 Check $103 Credit Card*

Stuffed Chicken Breast with Proscuitto and Sun Dried Tomatoes (GF)Braised Short Rib with Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato SauceNot Applicable
Choice of Entree - Saturday Banquet - Person #2 ($200 Check $206 Credit Card)*

Stuffed Chicken Breast with Proscuitto and Sun Dried Tomatoes (GF)Braised Short Rib with Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato SauceNot Applicable
Choice of Entree - Saturday Banquet - Person #3 ($300 Check $309 Credit Card)*

Stuffed Chicken Breast with Proscuitto and Sun Dried Tomatoes (GF)Braised Short Rib with Demi Glaze (GF)Herb Crusted CodVegetarian/Vegan - Butternut Squash Ravioli with Roasted Tomato SauceNot Applicable
E = Amount of Saturday Banquet*
Amount Owed for Single Events*
Payment:*

CheckCredit Card
If paying by check:*

Check - Full Amount
If paying by credit card:*

Credit Card - Full Amount
Credit Card Information
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