2023 Scientist of the Year Celebration
Reservation Form (Deadline April 28, 2023)
Name
*
First Name
Last Name
Suffix
Email
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Name of your Company, University or Foundation
Number of Reservation(s) at $200 per person
Please Select
0
1
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4
5
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8
Fair market value received per reservation $100
I would like to pay for ____ ARCS Scholar Reservation(s) at $200 per person
Please Select
0
1
2
3
4
5
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8
Fair market value received per reservation $100
I would like to make an additional contribution to the ARCS Scholar Award Fund in the amount of $
I would like to underwrite a portion of the SOY event in the amount of
$2500
$1000
$500
Other
Please enter the Name and Email address for each guest so that we may print nametags and email them any event updates (click the button below to add a guest). If you have any question, please contact Gwynn Thomas at 619-997-5219 or gwynn.thomas@outlook.com.
TOTAL AMOUNT $
Total Includes Processing Fee
TOTAL AMOUNT
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