Reception at 5:00 pm | Dinner at 6:00 pm
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Street Address
Street Address Line 2
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I/We will...
*
Yes - Attend the Dinner & Place an Ad
Yes - Attend the Dinner, but Not Place an Ad
No - Not Attend the Dinner, but Will Place an Ad or Make a Donation
I/We would like to sponsor at the following level -Check as many as apply
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( X )
Building of Torah (# of reservations based on amount)
$
5,000.00
Ambassador of Torah (# of reservations based on amount)
$
3,600.00
Guardian of Torah (# of reservations based on amount)
$
1,800.00
Diamond (# of reservations based on amount)
$
1,250.00
Platinum (includes 3 reservations)
$
750.00
Gold (includes 2 reservations)
$
500.00
Silver (includes 1 reservation)
$
360.00
Full Page (includes 1 reservation)
$
250.00
Half Page
$
150.00
Quarter Page
$
90.00
Dinner Reservation Only (no ad)
$
100.00
# Quantity
Donation Only
$
1.00
$ Amount
Total
$
0.00
1st Ad Copy:
2nd Ad Copy
# of Dinner Reservations
Please Select
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Seating Preference
Total
Bill Me Later Option
Please bill me later for payment
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