Spring Representative Assembly Registration Form

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2019 Luncheon Order Form

Saturday, April 27, 2019

Tan Tar A Resort
494 Tan Tar A Drive
State Route KK
Osage Beach, MO 65065

On Saturday, April 27 at 12 noon a luncheon will be held to recognize the Horace Mann Award winners. You may purchase tickets online with a credit card or a check made payable and mailed to Missouri NEA.

Entrées are served with a Farmer's salad made with Iceberg and spring mix lettuce, diced tomatoes, cucumber, eggs, carrots and Ranch dressing. Dessert will be your choice of New York cheesecake or carrot cake. Beverage service includes iced tea, water and coffee. The cost of each meal is $25, which includes tax and tip. Choose from the following:

Chicken Monterey
Lightly seasoned and sauteed chicken, tossed with sauteed mushrooms, tomato concasse and melted Monterey Jack cheese, served with mustard sauce, Yukon mashed potatoes and chef's choice of seasonal vegetables.
Rosemary & Black Pepper Crusted Pork Loin
Six ounces of sliced pork loin with wild mushroom Marsala sauce, served with rosemary roasted potatoes and chefs' choice of seasonal vegetables.
Parmesan Whitefish
Baked Parmesan coated Pacific whitefish, served with lemon cream sauce, roasted Yukon gold potatoes and chef's choice of seasonal vegetables.

If ordering lunch tickets for several people, provide the name and entrée choice for each individual. Lunch tickets will be distributed with delegate credentials at the R.A. Lunch tickets for non-delegates may also be picked up at the credentials table. All lunch reservations must be received by Wednesday, April 17.

Questions about the hotel and lunch reservations for the spring Representative Assembly should be directed to Pam Koetting and questions regarding delegates should be directed to Roxane Bly. Both can be reached by calling (573) 634-3202.

YOUR REGISTRATION IS NOT COMPLETE UNTIL YOU HAVE ENTERED YOUR PAYMENT INFORMATION AND RECEIVED A CONFIRMATION.

* denotes field is required.

Contact Information

	First Name*
	Last Name*
	Email Address*
	Address
	City
	State
	Zip Code
	Home Phone Number*
	Alternate Phone Number
	Local Association/School District*
	MNEA Role Category (local delegate, president, board member, etc.)
	Special Accommodations?

Luncheon Ticket Order

Chicken Monterey Lightly seasoned and sauteed chicken, tossed with sauteed mushrooms, tomato concasse and melted Monterey Jack cheese, served with mustard sauce, Yukon mashed potatoes and chef's choice of seasonal vegetables.
	# of tickets*	$25.00 each	*Full name of person(s) ordering Chicken*
Rosemary & Black Pepper Crusted Pork Loin Six ounces of sliced pork loin with wild mushroom Marsala sauce, served with rosemary roasted potatoes and chefs' choice of seasonal vegetables.
	# of tickets*	$25.00 each	*Full name of person(s) ordering Pork Loin*
Parmesan Whitefish Baked Parmesan coated Pacific whitefish, served with lemon cream sauce, roasted Yukon gold potatoes and chef's choice of seasonal vegetables.
	# of tickets*	$25.00 each	*Full name of person(s) ordering Parmesan Whitefish*
	Special Diet If you are vegetarian, vegan, gluten-free or have dietary restrictions due to food allergies, we will do our best to accommodate your request. What are your special dietary restrictions?
	# of tickets*	$25.00 each	*Full name of person(s) ordering a Special Diet*