The Chicago Assembly 2025 Holiday Event Guest Form

THE CHICAGO ASSEMBLY ANNUAL HOLIDAY BALL GUEST FORM

Friday, December 26, 2025
MEMBER: PLEASE ENTER NAMES AS THEY WILL APPEAR ON THE INVITATION.*

First NameLast Name
YesNo
MEMBER SPOUSE/GUEST: *

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices*

Rows	Beef	Fish	Veggie
Number

Entree Choices

Rows	Beef	Fish	Veggie
Number

Entree Choices

Rows	Beef	Fish	Veggie
Number

Entree Choices

Rows	Beef	Fish	Veggie
Number

Entree Choices

Rows	Beef	Fish	Veggie
Number

Additional Guest Fees

Eight guests are included in your membership dues. Guest fees above the 8 guests are $250.00 per guest.
PaypalZelleU.S. Mail
Payments via Paypal ($260.00 per person)
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Holiday Ball Guest
Holiday Ball Guest attendance

$260.00 Quantity

Total

$0.00
Payments via Zelle ($250.00 per person)
payments@thechicagoassembly.org, or by using the provided QR code below.
Payments via US Mail: ($250.00 per person)
Make checks payable: Chicago Assembly

Mail Payment:

The Chicago Assembly
PO Box 19438
Chicago, IL 60619
Should be Empty: