NAME _____________________________________________

E-MAIL ADDRESS ______________________________________

CCGTCC MEMBERSHIP NUMBER ________________________

FAVORITE CHIP _______________________________________

WHY SHOULD YOU BE IN THE SPLASHBAR CLICK?
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ARE YOU GOOD NATURED? YES_____ NO_____

ARE YOU WILLING TO BUY DRINKS, GET PIZZA AND DONUTS, PLAY POKER AND SOCIALIZE ALL NIGHT? YES_____ NO _____

Please submit this form someplace no later than sometime.