Fall Conference Convention 2025 Application

Fall Conference Convention 2025 Application

November 14 - November 16, 2025 - Ocean Place Resort & Spa, Long Branch, NJ
Application must be submitted by Saturday, November 1, 2025
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 Staying12
What package are you selecting? 1 Person*

1 Person - 2 Night Package Friday, November 14 - Sunday, November 16 @ $594 Check $612 Credit Card
What package are you selecting? 2 Persons*

2 Person - 2 Night Package Friday, November 14 - Sunday, November 16 @ $824 Check $849 Credit Card
Hotel check-in time is 4:00 PM. Early check-in may be available but not guaranteed. Please plan accordingly.
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 12, 2025 @ $182 Check $188 Credit CardThursday, November 13, 2025 @ $182 Check $188 Credit Card
Will you be requesting a room for a Hospitality Room?

YesNo
In the Hospitality Room, would you prefer:

1 Bed2 BedsNo Preference
If requesting a Hospitality Room, please add $364 (check) or $376 (credit card) for a 2 Night Package (Friday and Saturday nights). This room will be adjoining or next to your room and you will be responsible for it. Please remember that no one may stay in this room and there are no event tickets given with the room.
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 Sauce
Event Only Options - Complete only if you are NOT making room reservations and are planning to attend any function listed below.
Friday Picnic Party @ $87 Check per person $90 Credit Card per person*

1 Person2 Persons ($174 Check, $180 Credit Card)3 Persons ($261 Check, $270 Credit Card)4 Persons ($348 Check, $360 Credit Card)Not Applicable
C = Amount of Friday Picnic Party*
Saturday Luncheon @$37 Check per person $39 Credit Card per person*

1 Person2 Persons ($74 Check, $78 Credit Card)3 Persons ($111 Check, $117 Credit Card)4 Persons ($148 Check, $156 Credit Card)Not Applicable
D = Amount of Saturday Luncheon*
Choice of Entree - Saturday Banquet - Person #1 @ $106 Check $110 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 ($212 Check $220 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 ($318 Check $330 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
Make check payable to: New Jersey State Elks Association

Please mail check for full amount to:

Maureen Whalen

10 Doris Place

Bloomfield, NJ 07003

Deadline: November 1, 2025

Comments if needed:
Include dietary restrictions and any other comments. Be brief.
Should be Empty:

Fall Conference Convention 2025 Application

Application must be submitted by Saturday, November 1, 2025

Credit Card - Name on Card