July 2016 Event Registration Form Mail or bring to: Golden Opportunity
Golden Opportunity
1401 Jefferson Highway New Orleans, LA 70121 504-842-7000 NAME:
Home Phone: ___________________________ Cell Phone: _____________________________
Address:
City, State, Zip:
Important Notes: Effectively Immediately 1. 2.
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Please send in the Event Registration Form with your payment. All prices are listed are per person. If you register to attend an event on the registration form please note that all events will be NONREFUNDABLE (includes the ($5) NONREFUNDABLE transportation fee). If someone is on the waiting list, we’ll request that person make the check payable to you, send it to our office and we will forward the check to you. A credit will no longer be issued. If an event requires payment by check, submit separate checks for each event unless you are paying for more than one person for the same event. Please put the event name on the bottom of the check as some events have the same cost. Please SIGN your check. When attending “LUNCH BUNCH” please be prepared that this event will not return to the Primary Care & Wellness Center until event is over (approximately 2:30 p.m.). Please do not sign-up for this event if you have “Schedule Conflicts”!
July 1st (Friday): Members’ Monthly Potluck (Bring a dish and socialize with other members) 12:00 p.m. – 1:30 p.m. - Brent House – LeJeune Room □ attend □ will not attend July 5th (Tuesday): Members’ Monthly Meeting 10:00 a.m. – 11:30 a.m. – Brent House – Caldwell & LeJeune Rooms Light refreshments provided! □ attend □ will not attend July 8th (Friday): Lunch @ N’Tinni’s Restaurant and Shopping (Mandeville) $50.00 per person (Includes lunch and motorcoach transportation) Departure: 10:00 a.m. – Center for Primary Care & Wellness Building Return: 5:00 p.m. – Center for Primary Care & Wellness Building □ attend □ will not attend July 14th (Thursday): Louisiana State Police Headquarters Tour (includes State Fire Marshal, State Police Training Academy, Crime Lab & Emergency Operations Center) & Lunch (State Police Cafeteria “On You Own”) $25.00 per person (Motorcoach transportation) Departure: 7:30 a.m. –Center for Primary Care & Wellness Building Return: 5:00 p.m. –Center for Primary Care & Wellness Building □ attend □ will not attend
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July 2016 Event Registration Form Golden Opportunity NAME:
Home Phone: ___________________________ Cell Phone: _____________________________
Address:
City, State, Zip: _________________________
July 18th (Monday): Lunch Bunch - The Stuffed Crab (“On Your Own”) $5.00 per person (Ochsner bus fee) Departure: 10:30 a.m. –Center for Primary Care & Wellness Building Return: 2:30 p.m. – Center for Primary Care & Wellness Building □ attend □ will not attend July 19th (Tuesday): Seminar - “Hurricane Season – What You Need to Know!” Presented by: Hank Allen, Meteorologist, WGNO 10:00 a.m. – 11:30 a.m. – Center for Primary Care & Wellness - Camellia Room Light refreshments provided! □ attend □ will not attend July 28th (Thursday): Seminar - “Thyroid Function” Presented by: Nadia Fernandez, FNP 10:00 a.m. – 11:30 a.m. – Center for Primary Care & Wellness - Camellia Room Light refreshments provided! □ attend □ will not attend June 14th (Tuesday): Event Registration - GO Office (Center for Primary Care & Wellness) UPDATES Due to equipment problems, we will not be accepting credit cards at this time. Golden Opportunity Main Campus will now be known as “Golden Opportunity – OMC Jeff Hw y”. Please make all checks payable to “GO – OMC Jeff Hwy” and add the name of the event in the memo section of the check.
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