International Covered Dish Luncheon Registration Form

Employee Name(Required)

First Name Last Name

Department(Required)

I will be bringing(Required)

(Non-Alcoholic Beverages) No Cans. 2 Liter Bottles ONLY. If your beverage is not a 2 Liter Bottle, please specify.

I will bring(Required)

Please indicate the beverage you will be bringing(Required)

For example: Coke, Pepsi, Sprite, Iced Tea, Apple Juice, Orange Juice, etc.

If Other, please specify(Required)

Please provide a full sized pan. 4 inches deep.

Name of your dish(Required)

Country of Origin(Required)

Ingredients(Required)

Please indicate all ingredients used in your dish. If none apply, please answer none.

Allergen Information - My Dish Contains

Tree Nuts

Milk

Wheat

Soy

Eggs

Strawberries

Shellfish

Pork

Other

If other, please specify

If you are bringing a $20.00 donation, please bring cash to LaShon Blake in Board Relations(7th Floor).