HRC Ticket Order Form

Human Rights Annual Dinner Ticket Order Form

Thank you for your interest in the 2024 Human Rights Commission Annual Dinner Meeting. Space is limited and advanced registration is required. Please include your best contact information as we may have to contact you to review the details of your registration. Should you have any questions or need to contact us, please call our office at (812) 376-2532 or email us at humanrights@columbus.in.gov.
Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Ticket Selection

To select an option, please check the corresponding box to the left of the selection and then select a quantity. When you make a selection, you will see the corresponding subtotal appear along with the purchase total.
Selections*
prevnext( X )
Individual ticket(s)
Select the number of individual tickets you would like to purchase. Each ticket is $30.00 per person.

$30.00 Quantity
Item subtotal:$0.00



Table of eight (8) tickets
Select the number of tables of eight (8) tickets you would like to purchase. (For example, select 2 if you would like 2 tables for a total of 16 tickets.)

$240.00 Quantity
Item subtotal:$0.00



Donation
Would you like to donate the cost of a ticket? Donations support the attendance of others to the event including student winners, their parents and teachers, or those for whom cost prohibits participation.

$30.00 Quantity



** STAFF USE ONLY **
For staff use only. Use for registrations by check or cash.

$ Free Quantity



Total

$0.00
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The payment is ready! It will be completed once you submit the form.
Please list the name(s) and e-mail address(s) of attendee(s) (if known).
- Each attendee for whom we have an e-mail address will receive event information prior to the event.
- If you do not yet have guest/attendee information, you can contact us at a later time with details. You can also forward your order confirmation to them.
- If you have more guest(s)/attendee(s) than the space below allows, please contact us at 812-376-2532 or e-mail humanrights@columbus.in.gov after you've placed your order.
1. First Name Last Name Email
2. First Name Last Name Email
3. First Name Last Name Email
4. First Name Last Name Email
5. First Name Last Name Email
6. First Name Last Name Email
7. First Name Last Name Email
8. First Name Last Name Email
Do you (or any attendees in your party) require an accommodation? Use the space below to submit your request, such as a seat closer to the elevator, an ASL interpreter, or to notify us about dietary needs such as a gluten-free meal option or a peanut allergy.
Do you have any questions or need more information? Use this space to let us know and we will contact you.
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Human Rights Annual Dinner Ticket Order Form

Ticket Selection