47th ANNUAL INTERNAL MEDICINE RESIDENT AND FELLOW GRADUATION BANQUET

47th Annual Internal Medicine REsident and Fellow Graduation Banquet

Saturday, June 12
Panther Creek Country Club

3001 Panther Creek Drive

Reception 6 p.m.
Dinner 7 p.m.

Ceremony 8:30 p.m.

The Department of Internal Medicine cordially invites you and a guest to attend the 47th annual banquet honoring our residents and fellows.

Buffet dinner with chicken, steak and vegetarian selections. Cash bar for the evening event.

SPONSORSHIPS

Resident and Fellows | FREE
• Dinner and wine for residents and fellows, and one guest.

Additional Guest to Resident and Fellows | $45
• Dinner and wine as an additional guest to residents and fellows.

Faculty Member | $75
• Dinner and wine for one and a contribution for the Residents’ Banquet.

Faculty Member plus Guest | $150
• Dinner and wine for two and a contribution for the Residents’ Banquet.

FMV of each meal is $45. RSVP by June 4, 2021

Contact Information

First Name

Last Name

Address Line 1

Address Line 2

City

Country

State

Provinces

State/Province

Postal Code

Phone

Attendee Information

I am a:

Resident or FellowFaculty Member

Please indicate if you have any dietary restrictions:

Resident or Fellow Information

I will attend the banquet:

With a guestWithout a guestAdditional guest(s): $45 each

Name

Please indicate if your guest has any dietary restrictions:

Guest Information

Name

Please indicate if your guest has any dietary restrictions:

Guest Information

Name

Please indicate if your guest has any dietary restrictions:

Faculty Member Information

I will attend the banquet:

Without a guestWith a guest

Name

Please indicate if you have any dietary restrictions:

Guest Information

Name

Please indicate if your guest has any dietary restrictions:

Sponsorship

Additional Guest to Resident and Fellows

Quantity

$45.00

Total $

Sponsorship

Faculty Member Dinner

Quantity

$75.00

Faculty Member and One Guest

Quantity

$150.00

If you would like to make an additional donation to the program, please indicate the amount here.

Total $

Payment Information

Name on Card

Card Number

Code

Billing Email

Cybersource_Hidden_Fields

47th ANNUAL INTERNAL MEDICINE RESIDENT AND FELLOW GRADUATION BANQUET | SIU Foundation | SIU

SIU Foundation

Main Navigation

Contact Us