POLIDAZZLE Registration 2011

Please complete this form if you plan on attending POLIDAZZLE on Thursday, December 1, 2011, at the M STREET CAFE.

First name:

Last name:

Phone number (current cell phone number preferred):

Email address:

If you are Alumni/Alumnae, please provide us with the year in which you graduated...

Please note: A Trobec's coach bus provided by the Eugene J. McCarthy Center will be picking up Polidazzle attendees at 2:40 p.m. in front of the Gorecki Center, on Thursday, December 1, 2011. It will depart at 3:00 p.m. sharp. The plan is for the bus to arrive back on campus that evening between 9:30 p.m. - 10:00 p.m.

This transportation is free of charge. If you find other means of transportation to this event your travel expenses will not be reimbursed.

I will be using the coach bus provided by the McCarthy Center for transportation to and from Polidazzle:

	Yes
	No

There will be a $10 fine for those who have agreed to ride the transportation provided and fail to do so.

If you need to cancel your reservation for transportation on the bus, please contact Stacy Penk at [email protected] or 363-3266 by November 22, 2011. If cancellation is received by this date the $10 fine will not apply.

Faculty	Monastic (CSB/SJU)	Friend
Staff	Monastic (Other)	Alumni/Alumna
Student	SOT Student

POLIDAZZLE Registration 2011

I will be using the coach bus provided by the McCarthy Center for transportation to and from Polidazzle:

If you need to cancel your reservation for transportation on the bus, please contact Stacy Penk at [email protected] or 363-3266 by November 22, 2011. If cancellation is received by this date the $10 fine will not apply.

College of Saint Benedict

Saint John's University