45th Testimonial Registration

Testimonial Celebration

HONORING THE 45TH IMPERIAL POTENTATE, HON. ERIC R. MYERS, #23 (Ret.) Deadline is August 14, 2023!
Registration Form
Temple/Court/ Organization *
Name*

First NameLast NameTitle
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Deadline August 14, 2023

Luncheon - August 19, 2023 @ 12 PM (Noon)

JW Marriott Tampa

[Attire: Formal Regalia w/Fez]

Other Payment Options besides Credit Cards:

CashApp: $45thERM

Zelle: testimonial45th@gmail.com

Cashier’s Check or Money Order made payable to:

45th Testimonial Committee

P.O. BOX 7012 Tallahassee, FL 32314

Please select your ticket options below.

If you are unable to attend the celebration and wish to send a special gift please select the Bronze, Silver, Gold or Platinum donations...
Purchase Tickets*
prevnext( X )
Individual Ticket$154.80
(service fee included)

Quantity

Table$1,237.20
Table seats 8 (service fee included)

Quantity

Bronze Donation$150.00

Silver Donation$300.00

Gold Donation$500.00

Platinum Donation$1,000.00

Subtotal $0.00Tax $0.00Total $0.00
www.ericmyers.org

For additional information, email: Testimonial45th@gmail.com or contact:

John Goss 215.896.7618
TJ James 850.321.5269
Lorraine James 850.212.0054

Thank you for your well wishes and your gifts. We look forward to seeing you in August 2023!
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Testimonial Celebration