"*" indicates required fields CAPTCHATo reserve a seat and food payment must be received no later 10 days prior to the luncheon. The Luncheon Cost is $25.00 per person Type of Reservation* Member Guest/Visitor Name* First Last Your EmailPlease enter your email address. No EmailCheck the box below if you do not have email No Email Guest of: Phone*Diet Restrictions:Gluten FreeMenu Selection* Entrée 1 -Beef Stroganoff with a Creamy Mushroom Sauce on Pappardelle Noodles Entrée 2 – Tropical Chicken Salad with Spring Mix Greens, Avocado, Hearts of Palm, Onions,Tomato, Cucumbers in a Sweet Lime Vinaigrette Entrée 3 – #2 without Chicken Dessert: Strawberry Shortcake Seasonal Fruit Cup Will you be bringing a guest? Yes No Guest Information We are excited that you will be bringing a guest to the Luncheon. Please remember to have them complete the necessary guest waiver form which is located under the Activities Tab of the website.Guest Name* Guest First Guest Last Guest Phone*Guest Diet RestrictionsGluten FreeVegitarianVeganGuest Menu Selection Entrée 1 -Beef Stroganoff with a Creamy Mushroom Sauce on Pappardelle Noodles Entrée 2 -Tropical Chicken Salad with Spring Mix Greens, Avocado, Hearts of Palm, Onions,Tomato, Cucumbers in a Sweet Lime Vinaigrette Entrée 3 -# 2 Without Chicken Guest Dessert: Strawberry Shortcake Seasonal Fruit Cup PaymentNo Refunds or Late RSVP’s and No Substitutions at LuncheonsForm of Payment* Credit or Debit Card Check Luncheon Voucher Member Cost Price: Guest / Visitor Cost Price: Voucher Price: Total Due Payment by check or voucher is due within seven days of the reservation Make checks payable to: Palm Harbor Newcomers Club (PHNC) Mail to: Palm Harbor Newcomers Club Attn: Luncheons, 9609 Gretna Green Dr. Tampa, FL 33626 Billing InfoPayment MethodCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please click button once only. There may be a brief delay while the form processes.PhoneThis field is for validation purposes and should be left unchanged.
