Contact Information

Name

Organization

Address

City/State/Zip

Phone (000-000-0000)

Fax

Email Address of Contact (required)

Website (sponsors & patrons only) 

Ticket Order

Please reserve Patron Tickets @ $75 each for a total of $
     ($60 of each ticket is tax-deductible; patrons receive special recognition in the program and website)

Please reserve Friend Tickets @ $40 each for a total of $
     ($25of each ticket is tax-deductible)

Please reserve Tables of Preferred Seating for 8 @ $450 each for a total of $
     ($330 of each table is tax-deductible; table sponsors receive special recognition in the program and website)

I am unable to attend, but I am sending my tax-deductible donation of  $

Total Due:   $ 

If you make a reservation, you are responsible for the fee even if you do not attend.
Cancellations must be received by the posted reservation deadline.

Guest Names

Those who will attend the luncheon (this will be used for nametags ... be sure to include yourself!)