10th Annual Loving Civil Rights Award Dinner - Registration

Thank you for your support of the Connecticut Fair Housing Center!

All proceeds from this event will support the Center's mission to ensure that all people in Connecticut have equal access to housing opportunities.

Unable to attend, but still want to support the Center's work? Click here to make a tax-deductible donation in any amount.

Looking to submit payment for an event sponsorship or program ad? Click here for the sponsor/ad registration form.

Questions about registration, or want to register by phone? Contact Letty Ortiz at (860) 263-0722 or letty@ctfairhousing.org. Payments via check are also welcome. Please make checks out to CT Fair Housing Center and mail to CT Fair Housing, 60 Popieluszko Court, Hartford, CT 06106 - please be sure to include names(s) and meal choice(s) of attendee(s).

To review details about this year's event, visit www.ctfairhousing.org/lovingaward.

We look forward to seeing you on May 10th!

Individual Registration

Please provide details about the person attending and any guests, along with meal choice(s). A full table is 10 seats.

Individual Registration *	Quantity
$85 - Individual Ticket (enter quantity at right)

Registrant Details

Registrant Name

First Name

Last Name

Meal Choice

New meal choices this year! Beef - Flatiron Steak with Demi Glaze; Chicken - Chicken Artichoke; Fish - Mahi Mahi with Mango Salsa; Vegetarian - Stuffed Portabello Mushroom w/Spinach & Boursin; all served with salad, bread, potato and vegetable. (Please note any dietary restrictions/allergies in the space provided below.)

Beef

Chicken

Fish

Vegetarian

Organization/Company

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone

Verify Email

Guest Details

Please enter the names and meal choices of your guest(s):

Guest #1 Name

First Name

Last Name

Guest #1 Meal Choice

Beef

Chicken

Fish

Vegetarian

Guest #2 Name

First Name

Last Name

Guest #2 Meal Choice

Beef

Chicken

Fish

Vegetarian

Guest #3 Name

First Name

Last Name

Guest #3 Meal Choice

Beef

Chicken

Fish

Vegetarian

Guest #4 Name

First Name

Last Name

Guest #4 Meal Choice

Beef

Chicken

Fish

Vegetarian

Additional Guests?

Registering for more than 4 additional guests? Please list their names and meal choices here.

Anything Else We Should Know?

Please note any dietary restrictions/allergies, seating preferences (should we seat you with a certain person or group?), and any other important details.

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