October 19, 2014, 4–8 PM 12th Annual Fundraising Dinner

12th Annual
Fundraising Dinner
Featuring the MoTown Sounds
of the John King Dance Band
October 19, 2014, 4–8 PM
Sheraton Crossroads, Mahwah, NJ
Get ready to get down to the Hot sounds of MoTown at the 2014
Mary Therese Rose Fund dinner, TWO MO’ TIME!
Reserve your tickets for this special event by calling Jack Crilly at
201-394-5940 or e-mailing [email protected].
Ease into the evening with the sounds of the Motor City during the
hors d’oeuvre and cocktail hour. Then enjoy dinner and featured
artists, The John King Dance Band. Cool down at the end of the
evening with our delicious ice cream sundae dessert bar!
Make sure you bring your dancing shoes and we’ll see you on
October 19th for some hot times in MoTown - TWO Mo’ Time!
Your tax deductible contribution benefits local special needs kids
through The Mary Therese Rose Fund.
$160 Per Adult • $80 Per Child • $1200 Per
Table Of 10 • Table Donations (see reverse)
For room information or directions to The Sheraton Crossroads go to www.sheraton.com
Mary Therese Rose Crilly was born in 1998 with Joubert
Syndrome a rare genetic disorder which left her profoundly
disabled. Though physically limited, Mary’s limitless love and
courage inspired those closest to her to establish a fund in
her name to benefit special needs children being treated out
of The Valley Hospital Center for Child Development. The
Fund provides needed therapies and equipment that are so
often denied by insurance companies because of lifetime
insurance benefit limits or simple denial of reasonable claims.
Each year The Mary Therese Rose Fund helps families pay for
needed equipment like orthotics, braces, and standers. It also
funds activities such as horseback riding that are therapeutic
and brighten the lives of these special kids. It is the goal of The Mary Therese
Rose Fund to help these special children reclaim some of the simple joys of
childhood denied them by their disabilities.
Though Mary passed away in 2003 her brief life was filled with joy. In
gratitude, and to honor her memory, supporters of the Mary Therese Rose
Fund continue to work so that other special children can experience some of
childhood's simple joys as Mary did.
For more information on the Mary Therese Rose Fund,
go to www.marythereserose.org.
Please fill out and return this form by September 20, 2014 Check more than one box where applicable.
Completed form may be sent to: The Mary Therese Rose Fund, Inc. c/o Jack Crilly, 33 Wolfe Drive, Wanaque, NJ. 07465
Make checks payable to The Mary Therese Rose Fund, Inc.
Name:
Address
City
State
Phone
Zip
e-mail
INDIVIDUAL CONTRIBUTIONS. YES, I will attend. Please accept my donation of $
Adult(s) @$160 each
Children @ $80 each
($80 tax deductible)
($50 tax deductible)
for:
Tables of 10 @ $1200 each
($600 tax deductible)
BUSINESS PACKAGES (see reverse) $
Ad Book Entry (see reverse)
Silent Auction/Goody Bag Donation (see reverse)
NO, I cannot attend. Please accept my donation of $
Total Contributions
Paying by credit card? Please fill out the form on the back.
$
12th Annual Fundraising Dinner
Business Packages
Ad Book Rates
Quarter Page Ad - $300
Half Page Ad - $500
Full Page Ad - $1000
Table Donor Rates Sponsor a table for fund beneficiaries and their families in one of the following ways:
Temptation
$1,500
Provides one table of ten for fund beneficiaries.
Receive a 1/2 page in the One Mo’ Time ad book and logo on running slide show display. Placard bearing your
name and/or company logo on donated table.
Marvelette
$2,000
Provides one table of ten for fund beneficiaries.
Receive a full page in the One Mo’ Time ad book and logo on running slide show display. Placard bearing your
name and/or company logo on donated table.
Commodore
$2,500
Provides two tables of ten for fund beneficiaries.
Receive a 1/2 page in the One Mo’ Time ad book and logo on running slide show display. Placards bearing your
name and/or company logo on donated tables.
Supreme
$3,000
Provides two tables of ten for fund beneficiaries.
Receive a full page in the One Mo’ Time ad book and logo on running slide show display. Placards bearing your
name and/or company logo on donated tables.
Complete form, detach at dotted line and send with your donation to The Mary Therese Rose Fund, Inc. c/o Jack Crilly, 33 Wolfe Drive, Wanaque, NJ. 07465
Ad Book Art/Copy (all ad art and copy must be received by 9/20/14
Quarter Page Ad - $300
Half Page Ad - $500
Full Page Ad - $1000
Please mail your logo on disc or hard copy to: Jack Crilly, 33 Wolfe Drive, Wanaque, NJ 07465
or email in pdf or jpg format to [email protected]
Paying By Credit Card
Card Type
Visa
Card # —————————————————————————
MasterCard
Exp Date —————
Name (as it appears on card) ————————————————————————————
Signature ———————————————————————————————————
Address (MANDATORY) —————————————————————————————–
City ————————————————————— State ————— Zip —————––
Silent Auction Form
Donors, contributing item(s) to the Silent Auction will have their name or company name
displayed at the auction site.
If you are contributing to the Silent Auction please fill out the information below.
Item(s) being donated:
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