EESCC Year End Awards Banquet Registration Form (NO REFUNDS and NO "at the door tickets") (Pay onlin...

EESCC Year-End Awards BanquetRegistration Form(NO REFUNDS and NO "at the door tickets")(Pay online via PayPal, Debit or Credit Card)

Date: Saturday, November 7th, 2026

Time: 5:30 - 6:30 Social Hour with a No Host Bar

7:00 - 7:45 Dinner (Buffet style)

7:30 - 10:30 Entertainment and Awards

Cost: $40

Location: Pine Ridge Golf Club, 90333 Sunderman RD, Springfield

(just outside of Springfield in the Mohawk Valley)

Primary Guest Name

First NameLast Name

Phone #:

Email:

Primary Guest Fee

Note: NO late fee this year.

Primary Guest Late Fee

Guest 1:

Phone #:

Guest 1 Email:

Guest 1 Fee

Note: NO late fee this year.

Guest 1 Late Fee

Guest 2:

Phone #:

Guest 2 Email:

Guest 2 Fee

Note: NO late fee this year.

Guest 2 Late Fee

Guest 3:

Phone #:

Guest 3 Email:

Guest 3 Fee

Note: NO late fee this year.

Guest 3 Late Fee

Guest 4:

Phone #:

Guest 4 Email:

Guest 4 Fee

Note: A late fee of $5.00 will be applied if the Submittal Date (see below) is after October 15th.

Guest 4 Late Fee

Calculation

PayPal Amount:

USDEESCC Awards Banquet

Submittal Date:

MonthDayYearHourMinutesAM/PM Option

Note: After you click on "Proceed to Checkout" below ...

If you try Option #1 (Pay with my PayPal account) and your transaction does NOT go through successfully THEN try Option #2 ("Pay with Debit or Credit Card") fill in all the information required then click "Pay now as guest" at the bottom of the PayPal form. If you don't want a PayPal account click on the check mark besided "Create my PayPal account ...". It will turn into a round white dot.

*** Use Option #2 if you do not have a PayPal account - no PayPal account is required to use this option.

***** Sorry for any inconvenience this process might cause. *****

*** To Proceed to Checkout please enter a Primary Guest Name above. ***

PayPal Amount:*

PayPal Amount: