REGISTRATION FORM

Please call 507-732-7616 to register by phone

Name _____________________________________

Address _________________________________________________________

City, State, Zip ___________________________________________________

Home Ph#_________________________ Work #_______________________

E-mail Address _____ _____________________________________________

Please provide us with the following information:
Lunch preference (Please circle one)	Chicken Cordon Bleu (Ham & Swiss on Croissant)
	Turkey Bacon Ranch Wrap
	Egg Salad on Croissant
Have you completed the survey? (Please circle one)	Yes: enclosed Yes: sent separately No
What is your favorite ice cream flavor?

Mail or drop off registration and a check for $12 to:

Crossings
320 East Avenue
Zumbrota, MN 55992

Please make checks payable to "Crossings"

Questions? Call (507) 732-7616