Product Order Form
Please make sure to fill in the required fields and submit this form to complete your order. To pay by check: AIPC, P.O. Box 4512, Clearwater, FL 33758
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2025 Annual Membership
$
30.00
Polonaise Ball Ticket - 2025
$
150.00
Quantity
1
2
3
4
5
6
7
8
9
10
Polonaise Ball Ticket - 2025 - AIPC members
$
140.00
Quantity
1
2
3
4
5
6
7
8
9
10
Polonaise Ball Program Ad - full page
Please send ad details to aipctampabay@gmail.com
$
100.00
Quantity
1
2
3
4
5
6
7
8
9
10
Polonaise Ball Program Ad - 1/2 page
Please send ad details to aipctampabay@gmail.com
$
60.00
Quantity
1
2
3
4
5
6
7
8
9
10
Polonaise Ball Program Ad - 1/4 page
Please send ad details to aipctampabay@gmail.com
$
40.00
Quantity
1
2
3
4
5
6
7
8
9
10
Donation
Please adjust quantity to donate in $10 increments
$
10.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Special Instructions
Please let us know who you would like to be seated with and your choice of meal - beef,fish or veg
Payment Methods
Submit
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