EmailMeForm
Gentleman's Flavor Chef Registration Form
Entry fee is $20.00 which includes your toque (hat) and apron.
Name
*
First
MI
Last
Check one box below
*
Yes! I plan to participate in the 3rd Annual "A Gentleman's Flavor: Cooking with Flair."
No, I am unable to participate, please accept my donation
Donation Amount
$
Dollars
.
Cents
Gifts benefit the Youth Leadership Exploration Retreat
Signature Dish Info:
Food Item Category
*
Meat
Side
Salad
Soup
Bread
Dessert
Drink
Healthy Choice
Select one category
Name & Description of your signature dish
*
A creative and unique name for your special dish is encouraged.
Previous participant?
*
Yes
No
Personal information
Email
*
Phone
*
###
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###
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####
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Occupation
*
Where were you born?
Nominated by:
Community Involvement/Organization(s)
*
Life's Philosophy/Favorite Quote:
*
Please upload a picture of yourself that we may use in our video presentation at the event.
*
Please complete this form along with entry fee ($20.00) on or before Friday, April 19, 2019. Use the "chef registration" payment tab on the website page.
If you prefer mailing, send with check made out to: Upscale Studio, Inc.
c/o "A Gentleman's Flavor"
1842 Palisades Drive
West Palm Beach, Florida 33411
For additional information, please contact:
Regina Brown (561) 236-8625
Nichole Brown (561) 635-4966
Robin Clemons (561) 767-6397
Questions / Comments
I would like to receive email updates.
Please feel free to refer someone you think maybe interested in participating. Give us their name in the space below with contact info (email or phone #).