RSVP Form
HOSPAC Special Regional Leadership Reception

Featuring Speaker of the House Joe Straus
5:30 p.m. - 7 p.m. Sept. 27, 2010 
Club Giraud
707 N. St. Marys St., San Antonio


Will you be attending this event?
 Yes! I will attend. 
 No, I cannot attend.  
 
Have you made your 2010 contribution?  Yes  No. If no, please make your 2010 contribution today to attend:

     I am making my 2010 contribution:  Online  Via secure FAX (download form) By contacting HOSPAC 
      Please accept my pledge as a:       

* Please provide the following required information:

* Full name:  
(As it should appear on recognition displays)
* Relationship to hospitals:  
* Job Title:
* Organization Name:
* E-mail address:
* Direct daytime phone:  -   -   EXT 


Please list guest names as you would like them to appear on their name badges:

Guest #1:
Name:

 Guest #3:
Name:
Title: Title:
Organization: Organization:
Guest #2:
Name:		 Guest #4:
Name:
Title: Title:
Organization: Organization:

If you are not yet a 2010 Leadership Level member,
the Host Committee invites you to join today to attend this important event.


* This information is required, but will be kept confidential.

Please direct inquiries to Lisa Kepple at 512/465-1047 or lkepple@tha.org.