Trivia Night Registration                       

When: Thursday, July 29, 2010
Time: 5:30 pm to 9:00 p.m.  (Networking and hors d’oeuvres from 5:30 – 6:30)
Where: African American Museum of Iowa,  55 – 12^th Avenue SE, Cedar Rapids, IA        
 
Trivia Format: There will be 10 rounds of questions. Each round of trivia will include 10 questions. Each table will work together to complete an answer sheet. At the end of each round, the answer sheet will be submitted for scoring. At the end of the night, the top three teams with the most correct answers will receive prize money.
 
Networking Opportunity: Make new friends and meet new potential business contacts! Individuals may choose to be placed at a Networking Table and get to know nine other people over the course of the evening.  

Enjoy a Fun Evening Out with Family, Friends, and Colleagues: Form your own table and discover who from your circle knows the answers to questions big and small. You may also sign up individually to be placed at a networking table.

 Contact: Glenda Taylor at 319-551-4763 or the History Center at 319-362-1501 x 11 or email history@historycenter.org. 

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Contact_______________________ Business/Team Name _____________________ 
Address________________________________ City, State, Zip __________________
PhoneNumber: _____________________Email: ______________________________
o I wish to be placed a networking table. Entrance fee is $10.00 per person
o I wish to form my own team. A team may have a minimum of 6 players and a  maximum of 8. Please provide the names and phone numbers or email            addresses of each participant.  

1. __________________________________________________________________

2. __________________________________________________________________

3. __________________________________________________________________

4. __________________________________________________________________

5. __________________________________________________________________

6. __________________________________________________________________

7. __________________________________________________________________

8. __________________________________________________________________

Payment must be received in advance to complete reservation.
o Payment enclosed for ____ (# of players) @ $10.00 person =  $_______ (total)
o Paying by check, payable to the Carl & Mary Koehler History Center.
o Paying by credit card.        Visa        Mastercard   (Please circle)
Credit Card Number: _____________________  Expiration: ________   Code:_______                     
Submit to:
Carl & Mary Koehler History Center, 615 First Ave SE, Cedar Rapids, IA 52401