I. Personal Information
Male Female
II. Contact Information:
Please check the preferred method.
Home Phone:
Cell Phone:
Cell Phone:
Email:
III. Meeting Days
Check all that applies
On a typical week, the best day(s) for me to attend a meeting is:
Thursday
Monday
Friday
Tuesday
Saturday
Wednesday
On a typical week, the best time of day for me to attend a meeting is:
IV. Food/Drink Preferences:
Please check items of your choice. If your choice is not listed, please specify under "other".
Breakfast:
Cereal
Pancakes
Donuts
Dec. Coffee
Fruit Juice
Specialty Coffee
Muffins
Eggs
Fresh Fruit
Bagels
Biscuits
Yogurt
Orange
Juice
Reg.
Coffee
Milk
Lunch/Dinner:
American
Mexican
Italian:
Chinese
Coke
Diet Coke
Dr Pepper
Tea
Flavored Tea
Coffee
Root Beer
Diet Root
Beer
Sprite
Diet Dr
Pepper
Pepsi
Diet Pepsi
Sprite Zero
Orange
Grape
Water (non- carbonated)
Water (carbonated)
Snacks:
(Please fill in)
V. Special diets and/or food allergies
NO
YES
Thank you for your information!!!
Please press submit to finish.