Designer Information Form
Please complete & return to your Table Coordinator. List any additional information on the reverse.
Dining by Design is Thursday, November 2, 2017, at the Casa de Amistad in Harlingen.
Designers’ Contact Information:
Name:___________________________________________
Address:___________________________________________________________
Email:___________________________________________
Home Phone:___________________________ Cell:____________________________
Name:___________________________________________
Address:___________________________________________________________
Email:___________________________________________
Home Phone:___________________________ Cell:____________________________
Table Information:
Table Name:__________________________________________________________ Number of Guests:____________________
Table Description:_________________________________________________________________________________________
Color Scheme:__________________________________ Main Items/Props:___________________________________________
Please Select:
_____ I will provide my own table. The dimensions are:__________________________________________________
_____ I will use a 60” round table provided by the Casa de Amistad. I understand this seats a maximum of 8 guests.
_____ Please rent the following for me: _____ a 72” round table _____ # of 2.5’ x 8’ rectangular(s)
_____ I will provide my own chairs.
_____ I will use the standard metal chairs provided by the Casa de Amistad. Number needed:____________
_____ I must have access to electricity.
_____ Please consider the following special needs: ________________________________________________________
_____________________________________________________________________________________________________
Dining by Design will make every effort to accommodate your requests.
Table Sales:
_____ My table will be underwritten by:__________________________________________ Amount:_______________
_____ I will be responsible for selling my complete table.
_____ I will sell _____ (#) seats at my table. The Committee may sell _____ (#) seats at my table.
_____ I would like the Dining by Design Committee to sell my complete table.
Guests Seated at Your Table:
1. __________________________ paid _____ 6. _________________________ paid _____
2. __________________________ paid _____ 7. _________________________ paid _____
3. __________________________ paid _____ 8. _________________________ paid _____
4. __________________________ paid _____ 9. _________________________ paid _____
5. __________________________ paid _____ 10. _________________________ paid _____
Please make checks payable to the American Cancer Society.
_____ Check here if you continue with additional information on the reverse.