Please

Please
PL ATINUM BENEFACTOR ($50,000)
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RESERVE THE
FOLLOWING
COMPLETED FORM MUST BE RECEIVED
BY OCTOBER 5, 2015, TO BE INCLUDED
ON THE FORMAL INVITATION.
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($41,600 IS TAX-DEDUCTIBLE)
GOLD BENEFACTOR ($25,000)
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_______________________________________________________________________
FULL NAME
_______________________________________________________________________
COMPANY NAME
_______________________________________________________________________
ADDRESS
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CITY/STATE/ZIPCODE
_______________________________________________________________________
TELEPHONE
_______________________________________________________________________
EMAIL
SILVER BENEFACTOR ($15,000)
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complete information below or call (212) 496-4311.
_______________________________________________________________________
CREDIT CARD NUMBER
❑ AMEX ❑ MC ❑ VISA
EXP. DATE________________
_______________________________________________________________________
CARDHOLDER’S SIGNATURE
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Preferred seating for one table of 10
Tribute Journal full-page 4-color ad (silver location)
Listing on both invitation and program
($11,500 IS TAX-DEDUCTIBLE)
BRONZE BENEFACTOR ($10,000)
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PAYMENT INFORMATION:
Premium seating for one table of 12
Tribute Journal full-page 4-color ad (gold location)
Designation as an Associate Chair on all event materials
Logo rotation on digital media
($20,800 IS TAX-DEDUCTIBLE)
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_______________________________________________________________________
Best seating for two tables of 12
Tribute Journal full-page 4-color ad (premier location)
Designation as an Associate Chair on all event materials
Featured on pre-event online auction website
Logo on digital leaderboards throughout the evening and
bidding stations
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One table of 10
Tribute Journal full-page 2-color ad
Listing on both invitation and program
($6,500 IS TAX-DEDUCTIBLE)
FRIEND TICKET(S) ($1,000)
($650 IS TAX-DEDUCTIBLE)
I AM UNABLE TO AT TEND BUT WILL CONTRIBUTE $_____________________________
T O I N Q U I R E A B O U T S P O N S O R S H I P O P P O R T U N I T I E S P L E A S E C O N TA C T:
Ra c he l Wein s te in • 3 40 We s t 85 th Stre e t • Ne w York , NY 10 024
Te l: ( 21 2) 49 6 -43 0 5 • Fax: (212) 76 9 -2629 • RWe in s te in @voa-gn y. org