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Retirement/Farewell Reception Event Request Form

* Indicates required fields.

Client Information

*Who is this reception for?  
*Years of Employment:
*Current Title:
*Department or Office:
Lead Contact for the Reception
* Contact Name:  
*Phone Number:
*Email Address:

Event Information

*Has location been confirmed? Yes     No
STOP! You cannot submit this form until the location has been confirmed with Mark Hendrix ( or 660.562.1420).
*Number of guests expected:


These are only suggestions based on cost per person for a reception for 75-100 people. Indicate your choices or make requests and the event coordinator will work with the caterer's to stay under the $400 budgeted amount.

Sweets:  Cake
 Truffle Balls
*Cake Flavor:  White
 Half & Half
*Decorations and/or Text on Cake:
Trays:  Fruit Tray
 Veggie Tray
 Cheese and Cracker Tray
Munchies:  Zesty Chex Mix
 Sweet Chex Mix
 Traditional Chex Mix
 Mixed Nuts
 Kettle Chips with Ranch
Hot Dips:  Crab Rangoo with Wonton Triangles
 Spinach & Artichoke with Pita Chips
Cold Dips:  Humas with Pita Chips
 Fruit Salsa with Cinnamon Chips
Beverages:  Lemonade
Other Request:

Music Playlist

Make specific song, genre or artist requests:

Decoration Requests

Make decoration requests (theme, balloons, color, etc.):