inSIGHT in ACTION Registration and Benefactor Form

Please Select:*

I would like to be Benefactor (Individual Sponsor) - includes minimum of 2 tickets.I would like to register for this event

Benefactor Level:*

The Little Liar - $10,000+Tuesdays with Morrie - $5,000-$9,999For One More Day - $3,000-$4,999The Time Keeper - $1,500-$2,999Friend Sponsor - $500-$1,499

Benefactor Donation Amount

How would like your name listed as a Benefactor:

Please choose the type of ticket.*

Regular Ticket - $75Educator and Students - One complimentary ticket per person. Attendees must register separately.

How did you hear about this event:

Number of Tickets *

Name*

First NameLast Name

Date

Email*

example@example.com

Address (Florida address if applicable)*

Street Address

Street Address Line 2

CityState

Zip Code

Total:

INSIGHT THROUGH EDUCATION, INC. IS A PRIVATE, NONPROFIT 501(C)(3)CORPORATION AND RECEIVES 100% OF ALL FUNDS. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352, OR BY VISITING WWW.FDACS.GOV. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL OR RECOMMENDATION BY THE THE STATE. FL REGISTRATION #CH34845

Comments/Questions:

Payment Method*

Pay by credit card nowPay by check within 10 days.Pledge to be paid by 11/30/2024

Please make check payable to inSIGHT Through Education, Inc.

On the memo line please indicate inSIGHT in ACTION Benefactor.

Please mail your check to:

inSIGHT Through Education, Inc.
P. O. Box 33054
Palm Beach Gardens, FL 33420

All contributions will be gratefully acknowledged.

Total Amount:

USDDescription

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